Pro-transgender reforms announced in Pa.

David Weissman
  • New state policy allows transgender people to change gender on birth certificate without surgery.
  • Amendment to medical regulations removes payment prohibitions for sex reassignment services.
  • Medical Assistance amendment expected to cost about $9 million in state funds.

York City resident Felicia Baugher, a transgender woman, is hoping to be able to have gender-reassignment surgery within the next two years, but in the meantime, she might be able to change her birth certificate to reflect the fact that she's been living life as a female for nearly 20 years.

A recently announced state policy has made Pennsylvania the 12th state in the U.S. to remove the need for transgender people to provide proof of sex-reassignment surgery to change their gender on their birth certificate.

Baugher, upon hearing that news, said the ability to change her birth certificate would make her "very happy."

York City resident Felicia Baugher is happy that PA has announced that the state will no longer require proof of gender reassignment surgery for transgender women to change the gender on their birth certificate. Baugher, who has been living as a woman since 1998, said that a change to Medicare will help pay for her surgery, which she has been saving for.  John A. Pavoncello photo

Individuals 18 years or older with a Pennsylvania birth certificate can update their gender by having their physician submit a letter stating that they've had appropriate clinical treatment for gender transition, according to the policy. Those under 18 can have a parent request a correction to their child's gender field on the birth certificate.

Ted Martin, executive director of Equality Pennsylvania in Harrisburg, said the new policy would make it easier for transgender people to move on with their lives.

"This is an important step forward," he said.

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Baugher said all her other state-issued documents, including her driver's license, list her as female, which she has been since taking the necessary hormones beginning in 1998.

"I live 24-7 as a female," she said.

Change: Baugher's next step is gender-reassignment surgery, which should be more affordable thanks to a recently announced amendment to the state's Medical Assistance regulations.

The state Department of Human Services intends to remove language from the regulations that prohibit payment for certain services related to sex reassignment, according to a department bulletin.

Jeffrey Sheridan, a spokesman for Gov. Tom Wolf's office, wrote in an email that the amendment is related to a May U.S. Department of Health and Human Services ruling "that conclusively interpreted the Affordable Care Act to apply to medically necessary treatments associated with diagnoses of gender dysphoria for transgender persons."

The state's Department of Health had been sued for not covering this treatment, Sheridan wrote, but the lawsuit was settled as a result of this ruling.

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“Governor Wolf and his administration are committed to protecting all individuals, and this administration believes that no one should be discriminated against based on sexual orientation and gender identity and expression,” he wrote.

Baugher, 48, said she's made it her goal to have gender-reassignment surgery by the time she turns 50, but she's had difficulty saving money because health issues have limited her employment opportunities.

Baugher has been told she needs to raise at least $4,500 for insurance to cover the surgery, but she knows it could be more.

"I'm tired of being half and half," she said. "The sooner I get it done, the much happier I'll be."

Regulations: Spokeswoman Rachel Kostelac wrote in an email that the State Department of Human Services anticipates submitting final language for the amended regulations in October, at which time the Independent Regulatory Review Commission will have 30 days to review it before setting up a public meeting.

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The estimated costs for the amendment are more than $18 million during the next two fiscal years, including about $9 million in state funds, according to the department's bulletin.

Rep. Seth Grove (R-Dover) took exception with the costs because they never came up during during budget discussions, he said.

"We should always be questioning what we're spending taxpayer money on and why we're doing it," he said. "This was never mentioned; there needs to be more transparency."

Grove questioned whether taxpayers should be funding a procedure that is "not a life or death situation."

"We're just expanding benefits with no notification," he said. "(The Department of Human Services) is already one of the largest cost drivers in the state."

Grove also scoffed at the notion the change needed to be made to avoid a lawsuit.

"We're sued all the time," he said. "The General Assembly has sued the governor, and he hasn't changed anything."

Martin said the ruling was another step in the right direction for transgender equality but added that furthering nondiscrimination laws in the state is still an issue.

State legislation proposing to add sexual orientation, gender identity or gender expression to nondiscrimination laws has stalled in House and Senate committees for several years.

York City has its own ordinance offering protection for LGBTQ groups.

— Reach David Weissman at or on Twitter at @DispatchDavid.