Utah House advances insurance parity bill on transition and detransition care

The Utah House of Representatives voted on Feb. 5 to approve HB258, sponsored by Rep. Nicholeen P. Peck, R-Tooele, requiring private insurers to provide coverage for detransition procedures if they cover comparable transgender transition treatments.

The measure, titled Insurance Coverage Amendments, cleared the House following floor debate and two amendments to clarify how insurers would apply the policy.

Peck described the bill as a “simple” effort to create parity within private insurance plans.

“In the private insurance world, some private insurance companies are paying for transgender procedures but are not paying for detrans procedures,” Peck told colleagues. “We just want to make sure that if we’re covering one population of people, that we also cover the other population of people.”

The bill does not mandate that insurers cover gender-related procedures outright. Instead, it requires that if a private insurance plan covers hormone treatments or surgeries for gender transition, it must also cover comparable hormone treatments or surgeries for detransition.

Rep. Raymond Ward, R-Bountiful, proposed a substitute version of the bill, which Peck accepted as a friendly amendment. Ward said the updated language separates hormone treatments and surgical procedures to ensure the requirements run in parallel.

“If you’re covering hormonal treatments for the purpose of making a transgender transition, then you need to cover hormonal treatments for a detransition,” Ward explained. “If you are covering trans surgeries for the purpose of transition, then you need to cover surgeries for detransition.”

Ward said the substitute avoids a broader interpretation that could have required insurers to cover all detransition procedures if they covered any transition-related care.

During questioning, Rep. Karianne Lisonbee, R-Davis, asked whether hormone treatments could result in physical effects that might later require surgical intervention. She raised a hypothetical scenario involving a young person who received hormone treatment in another state and experienced changes to genital development.

Ward responded that many effects of hormone therapy reverse after treatment stops, though some do not. He added that certain surgical remedies in such cases are not well defined and have lower success rates, saying he preferred the bill’s approach of tying coverage directly to whatever transition services an insurer already provides.

The House later adopted an amendment from Rep. Shelley striking language that limited coverage to procedures an insurer “considers medically necessary.” Peck supported the change, saying the procedures referenced in the bill are elective and that removing the phrase would avoid confusion in how the requirement is applied.

In closing, Peck urged support for the measure, calling it “a good step forward” in addressing what she described as a growing detransition population.

HB258 passed the House 53-16 on party lines and now heads to the Senate for further consideration.