Gender-Affirming Healthcare

Massachusetts law about gender-affirming care

Access to gender-affirming care is legally protected in Massachusetts. In June 2022, the state passed An Act Expanding Protections for Reproductive and Gender-Affirming Care. This law constitutionally preserves and protects reproductive and gender-affirming health care in the Commonwealth, including for individuals who travel from out of state and the providers who serve them. In addition, this law requires Masshealth, GIC, and commercial health insurance to cover gender-affirming care.
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Facts about gender-affirming care

Gender-affirming care is a form of healthcare. It includes an array of services such as medical, surgical, and mental health services for transgender, nonbinary, gender non-conforming, and gender diverse people. Some people may want all of these services, some people may want one or two, and other people may want none. All of these paths are valid! The goal of gender-affirming care is to help people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity.

Gender-affirming care is safe and effective. Studies have linked gender-affirming care in both youth and adults to a decrease in depression and harmful behaviors. For example, a study from the Stanford University School of Medicine concluded that those who began hormone therapy in adolescence experienced less suicidal ideation, fewer mental health disorders, and less substance abuse than those who began such therapy later. Transgender surgical procedures have extremely low regret rates (less than 1%, as compared to a 4.8% regret rate for hip replacement surgery and a 7.7% regret rate for weight loss surgery).

Gender-affirming care is supported by every major US medical association. This includes the American Medical Association, which represents 271,660 doctors and medical students, the American Academy of Pediatrics, the largest professional association of pediatricians in the US, the American Psychiatric Association, the largest psychiatric organization in the world, the American College of Physicians, the largest medical-specialty organization and second-largest physician group in the United States (after the American Medical Association), and the American Nursing Association, the major professional organization representing registered nurses. 

Gender-affirming care is not new or experimental. It has been practiced for decades, and many of the procedures and medications were originally used to treat medical conditions in cisgender (non-transgender) people. The gender-affirmative treatment approach, which focuses on helping an individual align their gender presentation with their gender identity, was originally pioneered in 1919 at the Institute of Sexual Research in Berlin, until the institute was raided and its library burned by the Nazi party in 1933. The technique currently most commonly used for vaginoplasty was invented in 1956. GnRH analogues, which delay the onset of puberty, have been prescribed to cisgender children for almost 40 years, and to transgender youth since the late 1980s. Any treatment is given only with the informed consent of the patient or, in the case of minors, the consent of the parent and the assent of the youth.