Evidence map›Paper›PMID 38881495›Full record

ArticleHealth services research2024

Medicaid coverage for gender-affirming surgery: A state-by-state review.

Jonnby S LaGuardia, Madeline G Chin, Sarah Fadich, Katarina B J Morgan, Halena H Ngo, Meiwand Bedar, Shahrzad Moghadam, Kelly X Huang, Christy Mallory, Justine C Lee

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In one paragraph

Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jonnby S LaGuardiaDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.
Madeline G ChinDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.
Sarah FadichDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.
Katarina B J MorganHarvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA.
Halena H NgoHarvard Law School, Cambridge, Massachusetts, USA.
Meiwand BedarDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.
Shahrzad MoghadamDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.
Kelly X HuangDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.
Christy MalloryWilliams Institute, University of California Los Angeles School of Law, Los Angeles, California, USA.
Justine C LeeDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA.ORCID 0000-0002-8943-0837

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
PRECLINICAL EVALUATION OF NANOPARTICULATE MINERALIZED COLLAGEN GLYCOSAMINOGLYCAN MATERIALS IN CALVARIAL REGENERATIONR01DE028098 · NIDCR · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI LEE, JUSTINE CHIA · 2019 to 2023
$1.9M
Osteoclast modulatory biomaterials for skull regenerationR01DE029234 · NIDCR · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI LEE, JUSTINE CHIA · 2020 to 2024
$1.9M
Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins FoundationNational Institutes of Health/National Institute of Dental and Craniofacial Research R01DE028098National Institutes of Health/National Institute of Dental and Craniofacial Research R01DE029234NCATS NIH HHS UL1 TR001881NCATS NIH HHS UL1TR001881NIDCR NIH HHS R01 DE028098NIDCR NIH HHS R01 DE029234
6 · The paper itself

Abstract

objectiveTo systematically review Medicaid policies state-by-state for gender-affirming surgery coverage. DATA SOURCES AND STUDY

settingPrimary data were collected for each US state utilizing the LexisNexis legal database, state legislature publications, and Medicaid manuals. STUDY

designA cross-sectional study evaluating Medicaid coverage for numerous gender-affirming surgeries. DATA COLLECTION/EXTRACTION

methodsWe previously reported on state health policies that protect gender-affirming care under Medicaid coverage. Building upon our prior work, we systematically assessed the 27 states with protective policies to determine coverage for each type of gender-affirming surgery. We analyzed Medicaid coverage for gender-affirming surgeries in four domains: chest, genital, craniofacial and neck reconstruction, and miscellaneous procedures. Medicaid coverage for each type of surgery was categorized as explicitly covered, explicitly noncovered, or not described. PRINCIPAL

findingsAmong the 27 states with protective Medicaid policies, 17 states (63.0%) provided explicit coverage for at least one gender-affirming chest procedure and at least one gender-affirming genital procedure, while only eight states (29.6%) provided explicit coverage for at least one craniofacial and neck procedure (p = 0.04). Coverage for specific surgical procedures within these three anatomical domains varied. The most common explicitly covered procedures were breast reduction/mastectomy and hysterectomy (n = 17, 63.0%). The most common explicitly noncovered surgery was reversal surgery (n = 12, 44.4%). Several states did not describe the specific surgical procedures covered; thus, final coverage rates are indeterminate.

conclusionsIn 2022, 52.9% of states had health policies that protected gender-affirming care under Medicaid; however, coverage for various gender-affirming surgical procedures remains both variable and occasionally unspecified. When specified, craniofacial and neck reconstruction is the least covered anatomical area compared with chest and genital reconstruction.

Indexed as

Gender-Affirming SurgeryInsurance CoverageMedicaidCross-Sectional StudiesFemaleHealth PolicyHumansMaleState GovernmentTransgender PersonsUnited Statesgender‐affirming surgeryhealth policyinsuranceMedicaidpublic health

Identifiers

PMID38881495
PMCPMC11622269

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.