Trans Resource Navigator

Gender-affirming care in Virginia

Change detected, under review. An official source this page relies on changed recently. Part of this page may be out of date until we review it.

  • Page changed: Code of Virginia § 38.2-3449.1 (2026-10-05) · #186
Care for adults
Allowed
Care for people under 18
Allowed
Cardinal Care (Virginia Medicaid and FAMIS) pays for hormones
Covered
Cardinal Care (Virginia Medicaid and FAMIS) pays for surgery
Partly
Private plans must cover care
Yes, by law

Gender-affirming care is legal in Virginia for adults and for minors with parental consent. Virginia Medicaid (Cardinal Care) covers hormones and many surgeries, and state-regulated private plans may not exclude trans care. Virginia has no shield law, and access for minors has shrunk: the Richmond children's hospital program closed in 2025, and a new federal rule will bar federal Medicaid funding for youth care.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. Health centers near you
  2. Hormones by telehealth
  3. Clinics, programs, and funds
  4. Paying for care
  5. Rules for adults
  6. Rules for under 18
  7. Laws and court cases
  8. Sources

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Hormones by telehealth

These services prescribe hormones through video visits for people in this state. Point of Pride pays for a year and a half of care with several of them each spring.

  • Plume

    PaidNo Medicaid18+

    Trans-led telehealth service providing informed-consent hormone therapy, lab orders, prescriptions, and letters for surgery and documents, by app and video visit. Self-pay only since January 2026. A Point of Pride HRT Access Fund partner.

    About $99 per month ($90 in NY and NJ), which includes visits, messaging, prescriptions, and document letters. Labs and medications are billed separately and are often cheap with GoodRx or at a community pharmacy. Free for 18 months if you win a Point of Pride HRT Access Fund grant.

  • FOLX Health

    InsuranceTakes insuranceNo Medicaid18+

    LGBTQ-focused telehealth offering hormone therapy, PrEP, primary care, and mental health visits. Accepts major commercial insurance (Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare) but not Medicaid or Medicare. A Point of Pride HRT Access Fund partner.

    In-network with many commercial plans; self-pay membership about $69 to $98 per month all-inclusive.

  • Planned Parenthood

    Sliding scaleTakes insurance

    Many Planned Parenthood affiliates provide informed-consent gender-affirming hormone therapy alongside sexual and reproductive health care, on a sliding scale and with Medicaid. Most affiliates see adults 18 and older; a few see 16- and 17-year-olds with parental consent and a readiness letter. Many start hormone care by telehealth. Self-pay initial consults typically run about $120 to $250 before sliding-scale discounts.

Clinics, programs, and funds

Paying for care

Medicaid (Cardinal Care (Virginia Medicaid and FAMIS))[1][2][3][5][4]

Since December 2021, DMAS has affirmed coverage of gender dysphoria services for fee-for-service and managed care members. Under the Gender Dysphoria Supplement:

  • Hormones (including puberty blockers) are covered with a gender dysphoria diagnosis. For adults, the diagnosis can come from a gender-informed hormone prescriber; minors need a licensed mental health provider's assessment and parental consent.
  • Chest surgery (mastectomy, chest contouring, breast augmentation) is covered at 18+ with one mental health professional's support; augmentation requires 12 months of hormones unless contraindicated.
  • Genital surgeries (hysterectomy, phalloplasty, metoidioplasty, vaginoplasty, orchiectomy, and others) are covered at 18+ with two mental health letters, 12 months of hormones, and 12 months living in your gender (with exceptions).
  • Facial procedures (tracheal shave, genioplasty, forehead contouring, facial hair removal), behavioral health, and speech therapy are covered.
  • Not covered: voice surgery, hair transplants, liposuction, gluteal augmentation, pectoral implants, fertility preservation, and other listed cosmetic procedures.

Surgery needs prior authorization (form DMAS-P264 for fee-for-service; managed care plans use their own forms). The August 2026 federal CMS rule is expected to end federal funding for this care for members under 18 (under 19 in FAMIS/CHIP) starting in mid-October 2026.

Apply at Cover Virginia (coverva.dmas.virginia.gov), by phone, or at your local Department of Social Services.

Apply for coverage

Private insurance[9][10][11]

Va. Code § 38.2-3449.1 (2020) requires health carriers selling individual or group plans in Virginia to cover people without discrimination based on gender identity and bars them from denying or limiting sex-specific services because your sex assigned at birth or recorded gender differs. It defines medically necessary transition-related care to include therapy, continuous hormone therapy, related lab work, and gender reassignment surgeries.

If your plan denies care, appeal with the plan first, then file a complaint with the State Corporation Commission's Bureau of Insurance. Self-funded employer plans are federally regulated and may not be covered; the Trans Health Project has appeal templates. Individual plans are sold through Virginia's Insurance Marketplace (marketplace.virginia.gov).

File an insurance complaint

The rules in detail

Rules for adultsNo state restriction on care for adults.

No state restriction on care for adults. Several community clinics prescribe hormones using an informed consent intake (you review risks and benefits and sign consent; no therapist letter needed), and telehealth prescribing is legal.

If you have no insurance and little money, in rough order:

  1. Apply for Cardinal Care (Medicaid) at Cover Virginia. Adults qualify with income up to about 138% of the federal poverty level. It covers hormones, labs, and many surgeries.
  2. Health Brigade in Richmond serves trans patients who are uninsured or on Medicaid, after a financial screening.
  3. A community health center (find one at findahealthcenter.hrsa.gov) must see you on a sliding scale regardless of ability to pay.
  4. Point of Pride's HRT Access Fund pays for telehealth hormone care; He She Ze and We's Trans Wellness Fund helps Virginians bridge the cost of gender-affirming care.
[12][18][19][17][4]
Rules for under 18Legal. Virginia has no law banning gender-affirming care for minors (Movement Advancement Project, data as of September 2026).

Legal. Virginia has no law banning gender-affirming care for minors (Movement Advancement Project, data as of September 2026). Care requires parental or guardian consent.

Access is limited in practice. Children's Hospital of Richmond at VCU stopped providing gender-affirming care to patients under 19 on July 29, 2025, citing federal directives. A federal CMS final rule announced in August 2026 bars federal Medicaid and CHIP funding for gender-affirming care for people under 18 (Medicaid) or 19 (CHIP); it is expected to take effect in mid-October 2026. It does not ban care, but Medicaid-covered youth may lose coverage. Virginia has no shield law protecting patients or providers from other states' investigations.

[6][7][5][8]
Laws and court cases1 law
  • Va. Code § 38.2-3449.1: Health insurance may not discriminate based on gender identity or transgender status (HB 1429, 2020)

Sources

20 sources. Numbers in the text, like [1], point here.Show all
  1. Coverage of gender dysphoria services (bulletin effective December 10, 2021)Virginia Department of Medical Assistance Services, Regulation. accessed
    “DMAS affirms coverage of services related to gender dysphoria for fee-for-service (FFS) and managed care organization (MCO) Medicaid members.”
  2. Gender Dysphoria Supplement, Physician/Practitioner Provider ManualVirginia Department of Medical Assistance Services, Regulation. accessed
    “Medical (hormonal) therapy for gender dysphoria, including puberty suppressing hormone therapy, gender-affirming hormone therapy and associated laboratory services, will be covered”
  3. Citations, Medicaid coverage for transgender-related health careMovement Advancement Project, Organization. accessed
  4. Cover VirginiaVirginia Department of Medical Assistance Services, Official page. accessed
  5. Equality Virginia statement on federal rule stripping Medicaid coverage for transgender youth health care (August 25, 2026)Equality Virginia, Organization. accessed
    “The new CMS rule impacts youth under the age of 18 for Medicaid and 19 for CHIP—it does not ban care, but does prohibit federal Medicaid and CHIP funding from being used for medically necessary care for transgender youth.”
  6. Virginia state policy profileMovement Advancement Project, Organization. accessed
    “Negative Law: Laws Banning Best Practice Medical Care For Transgender Youth: No Negative Law”
  7. Gender-affirming care program updateChildren's Hospital of Richmond at VCU, Organization. accessed
    “a decision was made on July 29, 2025 to cease providing Gender-Affirming Care at Children's Hospital of Richmond at VCU for youth under age 19”
  8. Transgender healthcare shield lawsMovement Advancement Project, Organization. accessed
  9. Code of Virginia § 38.2-3449.1Virginia General Assembly, Legislative Information System, Law. accessed
    “Provide coverage under the health benefit plan without discrimination on the basis of gender identity or status as a transgender individual”
  10. File an insurance complaintVirginia State Corporation Commission, Bureau of Insurance, Official page. accessed
  11. Citations, private insurance nondiscrimination lawsMovement Advancement Project, Organization. accessed
  12. Trans healthHealth Brigade, Organization. accessed
    “Please note that Health Brigade only accepts transgender patients who are uninsured or have Medicaid.”
  13. Virginia Transgender Resource and Referral List (updated September 17, 2026)Virginia Department of Health, Official page. accessed
  14. Transgender healthcareWhitman-Walker Health, Organization. accessed
  15. Nationz FoundationOrganization. accessed
  16. Trans Wellness FundHe She Ze and We, Organization. accessed
  17. Find a Health CenterHealth Resources and Services Administration, Official page. accessed
  18. HRT Access FundPoint of Pride, Organization. accessed
  19. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed