Gender Dysphoria Treatment
Gender dysphoria is a condition where a person experiences clinically significant distress or impairment in social, occupational or other important area of functioning, of at least six months duration, because of a marked incongruence between the gender assigned (usually at birth) and their experienced/expressed gender identity. Diagnosis must be made by a TRICARE-authorized mental health provider.
- All services and supplies related to surgical treatment for gender dysphoria are not covered benefits.
- Non-surgical treatment for gender dysphoria, such as hormone treatments is a limited benefit and psychotherapy is a covered benefit.
- Referral and prior authorization requirements apply based on the type of treatment the beneficiary is receiving.
- See also Sex Changes.
To expedite the review process, providers may attach a Letter of Attestation in lieu of clinical documentation to the authorization request.
