Coverage Denied: Health Insurance Barriers to Gender-Affirming Care.

People who identify as transgender and non-binary (TNB) often experience higher rates of poverty, violence, suicide, unemployment, homelessness, discrimination, psychological distress, substance abuse, and HIV infection than people who do not identify as TNB, partly because of barriers to gender-affirming health care and supports. The current study builds on gender-affirming healthcare research by exploring health insurance-related barriers for TNB-identifying people. The study explored participants' health insurance barriers and how these barriers impeded gender-affirming care. Participants included a convenience sample of 96 clients from four organizations serving TNB clients. Results from the survey revealed insurance-related barriers to healthcare access for gender-affirming care, including financial constraints, complex policies that are difficult to navigate, cumbersome appeal processes, a general lack of information on gender-affirming care from insurance carriers, and a lack of geographically accessible facilities that insurance carriers will support. Suggestions for social work policy and practice are discussed.