Health Care | Transgender Health Care | New Hampshire

There are currently no laws restricting access to transition-related healthcare for transgender adults under New Hampshire state law.

In 2024, New Hampshire enacted RSA Chapter 332-M, which prohibits physicians from performing “gender genital reassignment surgery on minors in the state of New Hampshire.” In 2025, lawmakers introduced HB 377 and HB 712, which would also prohibit “breast surgeries” on transgender adolescents under the age of 18 and the prescribing and administration of puberty blockers and cross-sex hormones for transgender adolescents under the age of 18. It is likely that these harmful bills will become law.

It is important to understand that, as written, HB 377 and HB 712:

• Will not go into effect until January 1, 2026.
• Do not prohibit providers from continuing to prescribe or administer puberty blockers and cross-sex hormones to transgender adolescents under the age of 18 who have already begun care as of the January 1, 2026, effective date.
• Do not impose criminal liability for administering care.
• Do not prohibit providers from referring transgender adolescents under the age of 18 for care out-of-state.

If you believe that your care will be impacted, please contact us at NHMedicalCare@gladlaw.org

In general, under federal and New Hampshire state law, nearly all health plans cannot discriminate on the basis of sex, and, because the Supreme Court ruling in Bostock gegen Clayton Co. kam zu dem Schluss, dass jede Diskriminierung aufgrund der Geschlechtsidentität und sexuellen Orientierung eine Form der Diskriminierung aufgrund des Geschlechts ist. Fast alle Krankenversicherungen dürfen LGBTQ+-Personen nicht diskriminieren.

GLAD Law is currently challenging a New Hampshire employer’s decision to exclude transition-related healthcare from its self-funded employee health benefits plan on the basis of the business owner’s religious beliefs. Read more about that case.

New Hampshire Law

RSA 415:15 prohibits “discrimination on the basis of gender identity with respect to the availability of any covered services, medications, supplies, or durable medical equipment.” 

RSA 417:4, VIII(b) prohibits “discrimination on the basis of gender identity with respect to the availability of any covered services, medications, supplies, or durable medical equipment.”

The Patient’s Bill of Rights (RSA 151:21 XVI) protects the rights of patients admitted to hospitals in New Hampshire and states: 

“The patient shall not be denied appropriate care on the basis of age, sex, gender identity, sexual orientation, race, color, marital status, familial status, disability, religion, national origin, source of income, source of payment, or profession.” 

New Hampshire Insurance Department

Based on the above laws, in 2020 the New Hampshire Insurance Department issued a bulletin which stated in part: 

“. . .insurers are prohibited from denying, excluding, or otherwise limiting coverage for medically necessary services, based on an individual’s gender identity. Any offered services, medications, supplies, or durable medical equipment in a health insurance policy or contract must be provided to all individuals for whom a medical provider, in consultation with the individual patient, has determined that the services are medically necessary… Insurers should base coverage decisions on medical necessity rather than a person’s gender identity. The Department considers any blanket policy exclusions for health care services related to gender transition or any other form of gender dysphoria treatment as a violation of RSA 417:4, VIII(b) and RSA 415:15 in that such exclusions discriminate on the basis of gender identity.”

New Hampshire Medicaid

In 2017, the New Hampshire Department of Health and Human Services amended its rules to end the discriminatory exclusion from Medicaid coverage of gender-affirming surgeries.

New Hampshire Medicaid coverage includes the following gender-affirming services, providing there is documentation of medical necessity: 

• Mastectomy 
• Breast augmentation
• Hysterectomy 
• Salpingectomy
• Oophorectomy 
• Genital reconstructive surgery

Ja. Medicare und arbeitgeberfinanzierte Krankenversicherungspläne (auch Selbstversicherung genannt) unterliegen dem Bundesgesetz.

GLAD Law is currently challenging a New Hampshire employer’s decision to exclude transition-related healthcare from its self-funded employee health benefits plan on the basis of the business owner’s religious beliefs. Read more about that case.

Medicare

Im Jahr 2013 hob Medicare das Verbot der Kostenübernahme für die Behandlung von Geschlechtsdysphorie auf, da diese „experimentell“ sei, und begann, medizinisch notwendige Behandlungen für Geschlechtsdysphorie zu übernehmen.

Abschnitt 1557 des Affordable Care Act (ACA)

Section 1557 makes it unlawful for any health care provider that receives funding from the Federal government to refuse to treat an individual—or to otherwise discriminate against the individual—based on sex (as well as race, color, national origin, age or disability). Section 1557 imposes similar requirements on health insurance issuers that receive federal financial assistance. Health care providers and insurers are barred, among other things, from excluding or adversely treating an individual on any of these prohibited bases. The Section 1557 final rule applies to recipients of financial assistance from the Department of Health and Human Services (HHS), the Health Insurance Marketplaces and health programs administered by HHS.

Abschnitt 1557 gilt im Allgemeinen nicht für selbstfinanzierte Gruppenkrankenversicherungspläne gemäß ERISA oder für kurzfristige Pläne mit begrenzter Laufzeit, da die Unternehmen, die diese Pläne anbieten, in der Regel weder hauptsächlich in der Gesundheitsfürsorge tätig sind, noch finanzielle Unterstützung vom Bund erhalten.

Titel VII

For employers with 15 or more employees, Title VII bans discrimination on the basis of race, color, religion, sex and national origin in hiring, firing, compensation, and other terms, conditions or privileges of employment. Employment terms and conditions include employer-sponsored healthcare benefits. The Supreme Court decision in Bostock v. Clayton Co. made it clear that sexual orientation and gender identity discrimination are forms of sex discrimination. Although the decision is about wrongful employment termination, it has implications for employer-sponsored health plans and other benefits.

There are some limited circumstances where religious employers are exempted from the requirements of Title VII. Typically, these exceptions are limited to those employees who truly perform religious duties (such as a priest or religious instructor) and do not allow employers to discriminate against an employee, such as a janitor at a religious school, who is only present in the building outside of school hours and is not responsible for transmitting the faith.

1. First check to see if your health plan provides coverage for the type of treatment that you want by getting a copy of the plan’s “Summary of Benefits and Coverage.”
2. Die meisten Krankenkassen, sowohl öffentliche als auch private, haben detaillierte Anforderungen, die erfüllt werden müssen, um Kostenübernahme zu erhalten. Dies gilt insbesondere, wenn Sie eine Kostenübernahme für eine Geschlechtsumwandlungsoperation beantragen. Kontaktieren Sie daher Ihre Krankenkasse und fordern Sie eine Kopie der Anforderungen für die gewünschte Behandlung an. 
3. Arbeiten Sie mit Ihren Therapeuten und Ärzten zusammen, um sicherzustellen, dass Sie alle Anforderungen der Krankenkasse erfüllen. Die Dokumentation Ihrer Therapeuten und Ärzte ist der wichtigste Faktor für die Genehmigung Ihres Behandlungsantrags. 
4. Check what treatment requires preapproval. In most cases, any surgery will require preapproval, and the plan may only pay if you use a surgeon that takes their plan. 
5. Wenn Ihr Behandlungsantrag abgelehnt wird, informieren Sie sich über die Gründe. Wenn Sie weiterhin der Meinung sind, dass Sie Anspruch auf die Behandlung haben, können Sie das Einspruchsverfahren des Plans einleiten. In der Regel wird zunächst ein internes Einspruchsverfahren eingeleitet. Sollten Sie dort keinen Erfolg haben, können Sie sich manchmal an eine externe Stelle wenden. Halten Sie unbedingt die Fristen ein – andernfalls kann Ihr Einspruchsrecht erlöschen. 
6. Keep GLAD Law informed if you are denied treatment. GLAD Law may be able to offer suggestions that can help you win your appeal. You can contact GLAD Law Answers by filling out the form at GLAD Law Antworten oder telefonisch unter 800-455-GLAD (4523). 
7. Obwohl mittlerweile mehr Krankenkassen die Behandlung von Geschlechtsdysphorie übernehmen, kann der Prozess der Behandlung, insbesondere bei Operationen zur Geschlechtsumwandlung, zeitaufwändig und frustrierend sein. Es ist ein umfangreicher Dokumentationsaufwand erforderlich, und es kann schwierig sein, einen Chirurgen zu finden, der die Operation durchführt und gleichzeitig mit der Krankenkasse einverstanden ist. 
8. Scheuen Sie sich nicht, hartnäckig zu bleiben und einen neuen Antrag zu stellen, wenn Ihr Antrag abgelehnt wird. 

More and more surgeons who perform sex reassignment surgeries take health insurance. You should research surgeons carefully to find one who is a good fit for you. You can look at the list of in-network providers provided by your plan to see if they are included or if it includes any surgeons in your area, and if not, you can contact the surgeon’s office to determine if they accept your insurance. Most health insurance plans require that you use a medical provider in your network, but if your network does not include a surgeon who performs the services you need, you may be able to go out of network if you seek prior authorization from your plan.

If you are being discriminated against by a health care facility or provider, you can file a discrimination complaint with the New Hampshire Commission for Human Rights. See the “Diskriminierung” Issue Area for detailed information about how to do this.

If you have a health care plan that is regulated by the New Hampshire Department of Insurance, you can file a complaint with that agency: New Hampshire Insurance Department – Complaint Filing.

Wenn Sie einen Krankenversicherungsplan haben, der unter Abschnitt 1557 des ACA fällt, können Sie beim Amt für Bürgerrechte des US-Gesundheitsministeriums Beschwerde einreichen. Weitere Informationen finden Sie unter: So reichen Sie eine Beschwerde wegen Verletzung der Bürgerrechte ein. 

If you have a self-funded health care plan through an employer with at least 15 employees, you can file a discrimination complaint with the federal Equal Employment Opportunity Commission (EEOC). For more information, see the “Diskriminierung” Issue Area.