Bill de Blasio at a rally in New York City, May 21, 2019. (Jeenah Moon/Reuters)

New York City mayor Bill de Blasio said Sunday that, under his presidential administration, the cost of gender-reassignment surgeries would be covered by a publicly funded Medicare for All system.

“Absolutely. We have to respect everyone’s medical needs,” de Blasio said at the New York City Pride parade when asked by a reporter if his Medicare for All plan would cover the elective procedures.


“If someone needs a surgery to be full and to live their life fully — the idea is a health-care system that actually serves everyone to the fullest, not a health-care system that rations and causes people to struggle to get just a little health care,” he said.

.⁦@BilldeBlasio⁩ tells me gender reassignment surgery should be paid for by Medicare for All #NYCPrideMarch pic.twitter.com/7fC2NbQm9A — Zak Hudak (@cbszak) June 30, 2019

De Blasio is the first 2020 candidate to explicitly endorse classifying gender-reassignment surgeries as a medical necessity that would be covered under a Medicare for All system, rather than an elective surgery that would require a supplemental private insurance plan. Senator Bernie Sanders (I., VT.), who introduced a Medicare for All bill in 2017, has not said whether gender-reassignment surgeries would be covered under his proposal.


During his first debate performance last week, Julian Castro, who served as Secretary of Housing and Urban Development under President Obama, said his administration would cover abortions for transgender people under Medicare for All.

“I don’t believe only in reproductive freedom, I believe in reproductive justice. What that means is just because a woman or, let’s also not forget, someone in the trans community — a trans female — is poor does not mean they should not have the ability to exercise that right to choose,” said Castro, who presumably intended to refer to trans men not trans women, who are biological men incapable of bearing children.

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