By Andrea Zekis, Policy Director

We are excited to report that Oregon’s Department of Consumer and Business Services (DCBS) updated state guidelines on nondiscrimination for transgender people for insurance carriers, sending the clearest message yet that discriminating against people based on their gender identity is unacceptable. 

In the bulletin, Oregon Insurance Commissioner Laura Cali wrote: “DCBS is committed to ensuring that Oregonians do not face unfair discrimination in accessing any kind of insurance. DCBS will not allow forms that violate state or federal law related to discrimination against transgender persons.” 

Commissioner Cali’s statement and the guidance provided in the 2016 bulletin are critical to ending health care discrimination—nearly 40 percent of transgender people report being harassed in a medical setting or refused treatment because they are transgender.  Since the first Oregon bulletin was released in 2012, insurance carriers have continued historic denial of comprehensive coverage that first appeared in polices from the 1970s. Some carriers also asserted there was a lack of clarity in the first bulletin regarding guidance. The 2016 bulletin is more specific and more detailed and will be a significant step forward.

“This is the strongest, clearest message yet from a state that discrimination against transgender people in insurance is unacceptable, whatever form it takes,” said Harper Jean Tobin, Policy Director for the National Center for Transgender Equality (NCTE). “This bulletin provides clear answers to how both federal and state law apply, and we expect it will make a big difference for transgender Oregonians.”

Specifically, the 2016 bulletin provides greater clarity by focusing on gender identity and removing exclusions on the basis of it. The 2016 bulletin adds language about gender dysphoria, saying that gender dysphoria has to be equally covered to the same level as other mental health conditions and clarifies language on gender identity discrimination, so you have the same coverage regardless of gender. 

People who have the serious condition of gender dysphoria should be able to access care they need for their gender dysphoria—that’s in line with the state’s Medicaid program, the Oregon Health Plan. Treatments for gender dysphoria are not cosmetic, but medically necessary. 

Additionally, the 2016 bulletin aligns with the language and guidance included in the Affordable Care Act, which clearly defines discrimination on the basis of sex to include gender identity and sex stereotyping.

After numerous reports of transgender people being denied care, Basic Rights Oregon has advocated for clearer guidance from DCBS. Basic Rights Oregon staff worked with national partners like the NCTE to provide feedback on the draft bulletin that reduce barriers for transgender people accessing health care.

The newest bulletin is now available to download under the transgender justice heading of our resources page.