Under the other order, carriers must “exclude coverage for pediatric transgender surgeries or hormone treatments for the purpose of gender transition” for those under age 19. Image: Dmitry Naumov/Shutterstock.com
By: FEDweek StaffOPM has told health plan carriers that their 2026 offerings in the FEHB and PSHB programs must comply with two Trump administration executive orders on gender issues.
Under one, “all federal agencies are tasked with ensuring all federal policies and documents that require an individual’s sex list two options, male and female, and shall not make available third options or request ‘gender identity,’” OPM said in a letter to carriers as the annual process of negotiating coverage terms and premiums for the upcoming plan year is getting underway.
Under the other order, carriers must “exclude coverage for pediatric transgender surgeries or hormone treatments for the purpose of gender transition” for those under age 19, OPM said. That means excluding coverage such as “treatments prescribed for the purpose of delaying the onset or progression of normally timed puberty”; and treatments and surgical procedures to “align an individual’s physical appearance with an identity that differs from his or her sex.”
OPM added that it “recognizes that there are some bona fide medical conditions, such as precocious puberty, or therapy subsequent to a traumatic injury, where hormone treatments for individuals under the age of 19 may be lawfully covered by Carriers. Appropriate corresponding reductions in FEHB and PSHB premiums should be identified and included in benefit and rate proposals.”
For individuals age 19 or above, carriers “may propose to cover, but are not required to cover, transgender surgeries or hormone treatments for the purpose of gender transition.”
It concluded: “Carriers are permitted to propose additional benefits consistent with all applicable laws and guidance. OPM would like to stress, however, the commitment to providing the best available coverage at the lowest possible costs.”
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