Health insurers approving small but steady number of gender-affirming surgery cases

Irish health insurance providers have approved “gender affirming surgery” for a small but steady number of patients over recent years, according to the top providers in the market.

The VHI, which has almost half of the Irish health insurance market, has approved gender surgery treatment for fewer than 25 customers over the past three years, a spokesperson said.

The State-owned company has been covering gender affirming surgery since 2018 and all treatment is subject to prior approval, the spokeswoman said.

“In the past three years we have approved treatment for less than 25 customers. We cannot disclose the nature of that treatment as this is confidential information,” they said.

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Laya Healthcare, which has slightly more than a quarter of the Irish health insurance market, has covered “gender affirming surgery” since 2019, a spokesperson said.

The company would not break down the demand for the treatment on gender grounds or disclose the types of surgeries approved, which are only available to people aged more than 18 years.

“While we cannot confirm specific claim details for reasons of commercial sensitivity, we can confirm that we’ve seen a consistent, but low, demand for gender affirmation treatments since we introduced the benefit,” the spokesperson said.

“About one-quarter of all these claims were for gender affirmation surgeries, the majority of which took place in Irish hospitals.”

In July 2022, the company introduced a new benefit called gender affirmation support, which includes cosmetic surgery procedures that can be carried out here.

According to the website of the National Gender Service, which is a public service for adults run by the HSE, most gender affirmation surgery happen abroad.

“At present, under the public system, most surgeries are not provided in Ireland,” it says. “However, there are funding options available that can support you to have surgery abroad. We can help you to apply for that funding.”

[ The function, demand, limits and future of the National Gender Service ]

Last year it was reported that about 200 cases of publicly funded gender affirming surgery had been approved under the treatment abroad scheme between 2012 and 2020.

There are about 1,200 people on a waiting list to access the National Gender Service, which sees patients who are above 17 years of age and are suffering from gender dysphoria, or persistent distress because of their gender.

Laya Healthcare said more that half of the schemes it offers cover hormone therapy for gender dysphoria, while 80 of its schemes cover gender affirmation surgery abroad, with “once per lifetime cover” of up to €100,000 for treatments only available abroad.

Irish Life Health, which has approximately 20 per cent of the Irish health insurance market, said it has been providing cover for gender affirming surgery since November 2018.

“These procedures are carried out within the EU jurisdiction,” a spokesperson said. “Irish Life Health is not in a position to confirm the number of patients who have availed of this procedure as we do not disclose customer/patient sensitive information.”