Navigating Insurance for Mental Health as a Trans Adult: What to Know
Trying to use insurance for mental health care as a trans person can feel like running an obstacle course with no map. Between denied claims, outdated gender markers, and confusing coverage rules, it’s no wonder many of us give up before we even get care.
At The Source, we’re working to make this easier — but we also want you to understand the system you’re up against.
Why It’s So Complicated for Trans People
Insurance systems often:
Use binary gender markers to approve or deny care (e.g., denying coverage for “gender-incongruent” services)
Limit mental health coverage with high deductibles, small provider networks, or visit caps
Exclude trans-specific needs, even when they’re medically necessary
Lack transparency, making it hard to know what’s covered and what isn’t
It’s not your fault if this feels impossible. The system wasn’t designed with you in mind.
What You Can Do
Here are a few steps that can help:
Check your Summary of Benefits and Coverage (SBC) — Look for sections on outpatient mental health and telehealth coverage.
Ask directly about trans-competent providers — Many plans have an LGBTQ+ support line.
Request a case manager — Some insurers will assign someone to help coordinate trans-specific or behavioral health care.
Appeal denials — You have the right to appeal if your mental health care is denied, especially if it relates to gender.
Use diagnosis codes strategically — Sometimes the issue is how something is billed, not what was actually provided.
At The Source, we’re in-network with select payors and offer billing support so you’re not left navigating it alone.
If You’re Paying Out of Pocket
We know not everyone can use insurance. We’re developing sliding-scale options and partner funding for trans adults who need care now, not when a claim gets processed.
We believe finances should never be the reason someone goes without life-saving care.
Insurance should be a bridge to access, not a barrier. If you’re feeling stuck, we can help. Join our waitlist or reach out to learn more about how we handle insurance and billing.
