Beginning in 2026, federal employee health plans under FEHB and PSHB will no longer cover chemical or surgical gender-affirming interventions for any age. Counseling for possible or diagnosed gender dysphoria must still be covered and may include licensed providers offering faith-based counseling, including conversion therapy. The prohibition affects benefits for more than ten million federal workers and their family members and constitutes one of the largest rollbacks of transgender healthcare access in U.S. history. The changes appear designed to pressure federal employees toward detransition or exiting public service. The move directly contradicts longstanding interpretations of Section 1557 of the Affordable Care Act.
On Friday, the U.S. Office of Personnel Management issued a memo announcing that, beginning in 2026, all federal employee health plans will be barred from covering gender-affirming care - including hormone therapy and gender-affirming surgeries - for both transgender youth and adults. The sweeping prohibition affects health benefits for more than 10 million federal workers and their family members, marking one of the largest rollbacks of transgender healthcare access in U.S. history.
"For Plan Year 2026, chemical and surgical modification of an individual's sex traits through medical interventions (to include "gender transition" services) will no longer be covered under the FEHB or PSHB Programs. This exclusion expands upon Carrier Letter 2025-01a and applies regardless of age. As an exception, counseling services for possible or diagnosed gender dysphoria must still be covered. Covered counseling services must be provided by a licensed mental health provider and may include those who provide faith-based counseling," reads the memo.
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