Washington, DC – With the end of the Covid-19 Public Health Emergency (“PHE”) on May 11, transgender people across the country are fearing they will be unable to continue the healthcare they have received for the past three years. Obtaining critical healthcare, access to vital medications, including testosterone, as well as access to other life-saving benefits may become more difficult for the transgender patients.
“Since the beginning of the PHE in early 2020, telehealth has become a crucial part of the American healthcare system, especially for transgender people living in rural areas, in states with hostile policies on transition-related care, or otherwise distant from an affirming healthcare provider,” said C.P. Hoffman, Senior Policy Counselor for the National Center of Transgender Equality.
Unfortunately, how much an individual’s care will change depends on the type of care they receive, how they receive it, and who is financially responsible for the medical costs. Transgender people receiving care through in-person visits to a provider, paid for by either Medicare or private insurance are unlikely to see a significant impact to their care. However, trans people receiving care through telemedicine or whose insurance coverage is provided by Medicaid, may find their care disrupted.
With the end of the PHE, the telehealth restrictions that were once eased are now coming back into place. Of note, the Drug Enforcement Agency (“DEA”) issued emergency rules allowing for the prescription of controlled substances, (including testosterone, a Schedule III controlled substance), via telehealth. These temporary rules were initially set to expire with the PHE on May 11th, but on May 9th the DEA announced it would temporarily extend the telehealth exemption while it considers public comments on a permanent rule.
On March 31st, the National Center for Transgender Equality, alongside 61 other organizations, submitted a public comment to the DEA proposing changes to the draft rules. NCTE’s recommended changes included: 1) allowing all patients, not just those who had already begun care, to take advantage of the proposed 180-day transition period; 2) expanding the initial 30-day prescription prior to an in-person appointment to at least 90, and ideally 180, days; 3) allowing for appointments for lab work to qualify as the required in-person appointment; and 4) encouraging the DEA to work with other federal agencies on rescheduling testosterone to expand access.
While the full scope of the DEA’s final telehealth rules are not yet clear, transgender people who see their healthcare providers through telehealth visits, and who are prescribed a controlled substance such as testosterone, are encouraged to read through the NCTE PHE blog post, as well as schedule an in-person appointment to ensure full cover of the final DEA rules upon release.