Flag at a protest against Trump administration transgender policies in New York City, 2018. (Brendan McDermid/Reuters)

Vermont is expanding its Medicaid coverage to cover gender affirmation surgery for transgender patients under 21 who wish to undergo the procedures.

Vermont’s Medicaid insurance will now cover surgeries linked to gender dysphoria for minors who have obtained parental consent. Minors from 16 to 18 who have been legally emancipated from their parents are eligible for coverage without parental consent.


The Vermont Department of Health reported that nearly half of minors in the state depend on Medicaid for their health insurance.

Patients seeking gender surgeries must complete 12 consecutive months of living as the gender they identify as, and the desired surgery must be approved by a mental health professional and a doctor who deem it a medical necessity.

The 16 eligible surgeries include genital surgeries such as vaginectomies and phalloplasties as well as breast surgeries, mastectomies and breast augmentations.


Vermont joins most other U.S. states in covering gender-affirming treatment through Medicaid. New York and California are among states that cover such treatment for transgender children as well.

“Children with gender dysphoria believe they are not their biological sex,” the American College of Pediatricians said last year of California’s law. “A delusion is a fixed false belief. This bill proposes that foster children with gender dysphoria be socially affirmed into their delusion, and allowed to obtain experimental puberty blockers, and dangerous cross-sex hormones and surgery without parental consent.”

“Passage of this legislation will allow emotionally disturbed children to consent to dangerous life-altering procedures that will not reduce their risk for suicide in the long term,” the group said. “This would be a criminal outcome.”

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