Code of Virginia: Prohibited Discrimination Based on Gender Identity or Status as a Transgender Individual (§ 38.2-3449.1)

Health insurance carriers are barred from discriminating against individuals based on gender identity or transgender status in the provision of health coverage. Health plans must cover services without imposing restrictions, additional costs, or exclusions that treat transgender individuals differently from others. Carriers are required to treat covered persons consistent with their gender identity and may not deny coverage for health services ordinarily available to one sex simply because an individual’s gender identity differs from their sex assigned at birth. The statute also protects access to medically necessary gender affirming care when prescribed by a physician for gender dysphoria, which includes mental health treatment, hormone therapy, laboratory monitoring, and gender affirmation surgeries. While insurers may still determine whether a particular treatment is medically necessary under standard coverage rules, such determinations must be made using nondiscriminatory criteria aligned with recognized medical standards. Additionally, health carriers cannot impose higher premiums or contributions on transgender individuals than on similarly situated participants.