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Aug 16, 2022
Cigna's Approach to Gender-Affirming Care

The gender-affirmation process can be a long, complex, and emotional roller coaster. A survey of people who identify as transgender found nearly half — and 68% of transgender people of color – have faced discrimination when getting care, causing many to skip routine care as a result.

Enter Cigna's My Personal Champion team, which works with Cigna Health Plan customers (including our employees) to make gender-affirming care as simple and easy as possible. The team works to ensure people can avoid obstacles while they get the services they need.

Those services can include hormone therapy, speech therapy, mental health care, and surgeries. The team also helps customers find community support groups and provides support for social transitioning.

Connecting Customers With Care, Person to Person

Members of the My Personal Champion team often begin a conversation by asking the customer’s preferred name and pronouns.

“That’s really impactful for customers,” said Brittany Thomas, customer service analyst and a member of Cigna’s My Personal Champion team. Records may still reflect their birth name, which the customer may no longer use.

The team also knows how to find the right providers for each customer, despite a shortage of providers that specialize in this kind of care. Historically, medical schools have not taught gender affirmation; as a result, the transgender community has experienced significant inequities [PDF] in access to care and outcomes.

The My Personal Champion team works to build connections with care teams and providers who work with people who are transgender. The Cigna team also proactively intervenes and monitors claim activity to prevent obstacles and move things along from an authorization standpoint. One goal is to prevent frustration, keeping in mind the customer may be going through a tough time emotionally.

“I know one of the challenges people face in the doctor’s office is being called the wrong gender pronoun,” Thomas said. “That affects them negatively and can impact the relationship. Finding doctors that specialize in gender-affirming care is important.”

Success on a Deadline

Late in 2021, Thomas connected with Addie (whose name has been changed to protect her privacy), a customer seeking facial feminization services. After finding an in-network provider for Addie’s first procedure, Thomas tracked down approvals for two more procedures. Only then did she learn that Addie’s employer would be changing health insurers on January 1. That meant Addie needed to complete her treatments by December 31. If not, she would have to begin the process all over again with new authorizations, new providers, and her new insurance company.

“We worked to get the authorization pushed forward so that she could have the services done in the 2021 plan year,” Thomas said. “We were successful in doing that.”

Addie calls Thomas the “perfect embodiment” of the My Personal Champion program. “I truly felt she was in my corner 100% of the way, and I would not have been able to navigate the difficulties of trans-affirming health care without her,” Addie said.

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