{"doi":"10.1111/1475-6773.14338","title":"Medicaid coverage for gender‐affirming surgery: A state‐by‐state review","abstract":"OBJECTIVE: To systematically review Medicaid policies state-by-state for gender-affirming surgery coverage. DATA SOURCES AND STUDY SETTING: Primary data were collected for each US state utilizing the LexisNexis legal database, state legislature publications, and Medicaid manuals. STUDY DESIGN: A cross-sectional study evaluating Medicaid coverage for numerous gender-affirming surgeries. DATA COLLECTION/EXTRACTION METHODS: We previously reported on state health policies that protect gender-affirming care under Medicaid coverage. Building upon our prior work, we systematically assessed the 27 states with protective policies to determine coverage for each type of gender-affirming surgery. We analyzed Medicaid coverage for gender-affirming surgeries in four domains: chest, genital, craniofacial and neck reconstruction, and miscellaneous procedures. Medicaid coverage for each type of surgery was categorized as explicitly covered, explicitly noncovered, or not described. PRINCIPAL FINDINGS: Among the 27 states with protective Medicaid policies, 17 states (63.0%) provided explicit coverage for at least one gender-affirming chest procedure and at least one gender-affirming genital procedure, while only eight states (29.6%) provided explicit coverage for at least one craniofacial and neck procedure (p = 0.04). Coverage for specific surgical procedures within these three anatomical domains varied. The most common explicitly covered procedures were breast reduction/mastectomy and hysterectomy (n = 17, 63.0%). The most common explicitly noncovered surgery was reversal surgery (n = 12, 44.4%). Several states did not describe the specific surgical procedures covered; thus, final coverage rates are indeterminate. CONCLUSIONS: In 2022, 52.9% of states had health policies that protected gender-affirming care under Medicaid; however, coverage for various gender-affirming surgical procedures remains both variable and occasionally unspecified. When specified, craniofacial and neck reconstruction is the least covered anatomical area compared with chest and genital reconstruction.","journal":"Health Services Research","year":2024,"id":438548,"datarank":0.42414999884906546,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0644657079293098,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0644657079293098,"corpus_percentile":56.17699388875996,"corpus_rank":5666,"citation_count":10,"citer_count":7,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.7807,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1094209,"name":"Madeline G. Chin","orcid":"0000-0001-9974-9254","position":1,"is_corresponding":false},{"id":1248709,"name":"Sarah K. Fadich","orcid":"0000-0003-4508-0684","position":2,"is_corresponding":false},{"id":1090909,"name":"Katarina B. J. Morgan","orcid":null,"position":3,"is_corresponding":false},{"id":1249233,"name":"Halena H. Ngo","orcid":null,"position":4,"is_corresponding":false},{"id":267051,"name":"Meiwand Bedar","orcid":"0000-0003-1747-6665","position":5,"is_corresponding":false},{"id":1039389,"name":"Shahrzad Moghadam","orcid":"0000-0002-9871-4890","position":6,"is_corresponding":false},{"id":918686,"name":"Kelly X. Huang","orcid":"0000-0001-9092-5135","position":7,"is_corresponding":false},{"id":1249234,"name":"Christy Mallory","orcid":null,"position":8,"is_corresponding":false},{"id":336613,"name":"Justine C. Lee","orcid":"0000-0002-8943-0837","position":9,"is_corresponding":false},{"id":1039388,"name":"Jonnby LaGuardia","orcid":"0000-0001-7661-9035","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-19T02:00:43.618468Z","pmid":"38881495","pmcid":"PMC11622269","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}