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 v. Clayton Co. concluded that all gender identity and sexual orientation discrimination is a form of sex discrimination, nearly all health plans cannot discriminate against LGBTQ+ people.

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

Yes. Medicare and employer health plans that are self-funded (also known as self-insured) are governed by federal law.

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

In 2013, Medicare removed the ban on coverage for treatment of gender dysphoria because it was “experimental” and began to cover medically necessary treatment for gender dysphoria.

Seksyon 1557 nan Lwa sou Swen Sante Abòdab (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.

Anjeneral, Seksyon 1557 la pa aplike pou plan sante gwoup ki finanse tèt yo anba ERISA oswa plan kout tèm ki gen yon dire limite paske antite ki ofri plan yo tipikman pa prensipalman angaje nan biznis bay swen sante, ni yo pa resevwa asistans finansyè federal.

Tit 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. Pifò plan asirans, ni piblik ni prive, gen egzijans detaye ki dwe satisfè pou jwenn pwoteksyon. Sa a patikilyèman vre si w ap eseye jwenn pwoteksyon pou yon operasyon ki gen rapò ak tranzisyon. Kidonk, kontakte plan sante w la epi mande yon kopi egzijans pou tretman w ap chèche a. 
3. Travay avèk terapis ak doktè ou yo pou asire w ke ou satisfè tout egzijans plan sante a. Dokimantasyon ki soti nan terapis ak doktè ou yo se faktè ki pi enpòtan pou detèmine si demann tretman ou an ap apwouve. 
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. Si yo refize demann tretman w lan, chèche konnen rezon ki fè yo refize w la, epi, si w toujou panse ou kalifye pou tretman an, swiv pwosesis apèl plan an. Anjeneral, pral gen yon pwosesis apèl entèn anvan, epi, si w pa reyisi la, pafwa ou ka fè apèl nan yon ajans ekstèn. Asire w ke ou respekte dat limit yo—si w pa respekte yon dat limit, sa ka otomatikman mete fen nan kapasite w pou fè apèl. 
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 Repons Lalwa GLAD oubyen pa telefòn nan 800-455-GLAD (4523). 
7. Malgre ke plis plan sante kounye a kouvri tretman pou disfori sèks, pwosesis pou jwenn tretman, sitou pou operasyon ki gen rapò ak tranzisyon, ka pran anpil tan epi li ka fwistre. Yo bezwen anpil dokiman epi jwenn yon chirijyen ki fè kalite operasyon an, epi ki akseptab tou pou plan sante a, ka difisil. 
8. Pa pè pèsiste epi depoze dosye a ankò si yo refize ba ou. 

De pli zan pli chirijyen ki fè operasyon pou chanje sèks pran asirans sante. Ou ta dwe fè rechèch sou chirijyen yo ak anpil atansyon pou jwenn youn ki bon pou ou. Ou ka gade lis founisè ki nan rezo a ke plan ou an bay pou wè si yo enkli oswa si li gen ladan nenpòt chirijyen nan zòn ou an, epi si non, ou ka kontakte biwo chirijyen an pou detèmine si yo aksepte asirans ou an. Pifò plan asirans sante egzije pou ou itilize yon founisè medikal nan rezo ou a, men si rezo ou a pa gen ladan yon chirijyen ki fè sèvis ou bezwen yo, ou ka kapab soti nan rezo a si ou mande otorizasyon alavans nan men plan ou an.

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 “Diskriminasyon” 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.

Si ou gen yon plan swen sante ki gouvène pa Seksyon 1557 nan ACA a, ou ka depoze yon plent nan Biwo Dwa Sivil Depatman Sante ak Sèvis Sosyal federal la. Pou plis enfòmasyon, gade: How to File a Civil Rights Complaint. 

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 “Diskriminasyon” Issue Area.