Does affordable, accessible health care for trans people exist in 2026?

Frustrated that gender-affirming care isn't covered under your health plan? We share options and resources for trans-inclusive healthcare in the United States.

Unfortunately, health insurance coverage is changing for many folks in 2026. And if people are no longer eligible or can no longer afford an insurance plan, we look for alternatives. Self-employed entrepreneurs may find ourselves considering plans for emergency coverage, but which frustratingly do not cover gender-affirming care.

I did a deep dive into health plans for entrepreneurs, and was shocked by what I found in basically every plan's guidelines. Gender affirming care, including but not limited to hormone therapy and surgery: not covered. Uh oh.

I'm lucky to have a state-subsidized insurance plan that covers gender affirming care, and my research has really made it clear how unusual this is.

For example, let's look at Solo Health Collective, one of the few insurance plans available for freelancers. They offer a PPO plan for solopreneurs, covering eligible expenses 100% after a deductible.

Solo Health Collective covers hormone medications like estradiol and testosterone, but not for trans people. Their general exclusions include: "Gender Transition: Treatment, drugs, medicines, services, and supplies for, or leading to
and including, gender transition surgery." I asked, and their support team confirmed via email that testosterone is listed on their formulary but is not a covered service for an assigned female at birth person.

I'm actually not trying to throw Solo Health Collective under the bus here. They offer better benefits than a lot of plans.

Medical cost sharing plans can be far worse in terms of benefits for trans people. They can have so many exclusions, such as delivering a baby if the parent was unmarried at conception, ADHD, autism, mental health, abortions, contraception, chronic conditions, and more. All the cost sharing plans that I researched don't cover gender-affirming care for trans people.

Fun times.

So where can we get inclusive, affirming, necessary health care as trans people?

I'll share some options in this post. These will not work for everyone, but perhaps it may be helpful to see an overview of what's out there.

I am not a doctor or medical professional, and none of this is medical advice. Please do your own research and consult a medical professional if you are able to.

Why isn't gender-affirming care covered?

I kept digging through these plan guidelines, frustrated at how they specifically exclude gender-affirming care. Why? I asked myself.

After some reflection, while I don't know for sure, I suspect that the answer is very simple: it's less expensive for them to not cover gender-affirming care if they aren't required to.

It's infuriating, though, that essentially equivalent care is often covered for people who aren't trans, including hormone therapy and chest reconstruction.

I believe that gender-affirming care is medically necessary. I wish gender-affirming care was more accessible as it makes people's lives better.

Can we find affordable health providers that are trans-inclusive?

It is definitely harder to find good and inclusive healthcare providers. I've done a bunch of research and found some options which I'll share with you.

(If you're looking at insurance plans yourself, The Advocates For Trans Equality's Trans Health Project offers advice for what to search for in the guidelines for insurance plans, to figure out if gender-affirming care is covered or not.)

GenderGP

GenderGP offers hormone therapy from licensed US clinicians for $29.99/month. They currently operate in eight US states. While this does not include the price of prescription medications or labs, it seems like an inclusive way to receive prescriptions.

Folx Health

Folx Health offers a variety of health services via telehealth with LGBTQ+ inclusive providers. They have a membership model where you pay monthly and then additionally for appointments. Folx offers primary care, gender-affirming care, therapy, and reproductive healthcare.

Plume Clinic

Plume Clinic is a virtual clinic for trans and gender-nonconforming people. They prescribe hormone therapy and treat a number of conditions including allergies and acne. I have heard anecdotally that they focus more on transfeminine folks.

Planned Parenthood

Most Planned Parenthood health centers provide gender-affirming hormone therapy and referral letters. Planned Parenthood offers some help paying for your care.

GoodRX

GoodRX offers coupons, price comparisons, and discounts on prescription medications, whether or not you have insurance. You may be able to lower your cost of medications if you search for your prescriptions in GoodRX before heading to the pharmacy.

Medical tourism

Some clinics in countries outside the US specialize in gender-affirming surgeries, and take cash, not insurance. Be sure to check how reputable the surgeon is, and evaluate reviews of the practice. Point of Pride shares some good advice for traveling for gender affirming surgery in another country.

Moving to states with state-subsidized healthcare

Okay, this sounds a little drastic, and it is. But it's worth understanding that in some US states, you may be able to access subsidized insurance plans that cover gender-affirming care. Massachusetts with its MassHealth and ConnectorCare plans is at the top of the list. California and New Jersey are also worth considering, as well as the rest of the ten states that offer additional subsidies beyond federal assistance. Yes, these states can be expensive to live in, but if you have significant health expenses, I recommend doing the calculation.

DIY HRT

Be aware that alternatives to legally prescribed hormone replacement therapy exist online, particularly for transfeminine gender-affirming hormones. Send me a message if you need more info about such resources.

Mutual aid, fundraisers, & grants

We help each other out in the trans community often with mutual aid requests and fundraisers. Necessary medical expenses are a pretty good reason to ask for aid, in my opinion!

Some organizations provide grants and supplies for trans people:

Point of Pride’s Annual Transgender Surgery Fund

List of grants and resources curated by Trans Lifeline

Peer support groups

Look for local and/or online trans support groups - while this is not medical care, it can be incredibly helpful to receive empathy and advice from a community who is likely to understand. People in local groups can also recommend providers or resources specific to your location.

We are all in this together

Accessing healthcare as a trans person can be difficult, and it is not made easier by the extensive restrictions on health care plans. However, we do have some options, and hopefully, this post has provided some ideas.

Your health is important, whether you're trans or not. Advocating for your own access to quality care, if you are able, helps our community as well as your body.

I wish you luck finding health care options that work for you.

How's your health plan search going? Found anything to recommend? Let us know in the comments.