Policy: Testosterone, Injectable
Policy Number: ING-CC-0026
Last Update: 2021-10-25

Youth Services:

Testosterone injection are considered medically necessary for transgender individuals who meet ALL the following criteria:

1. Individual is 16 years of age or older; and
2. Individual has a diagnosis of gender dysphoria/incongruence or gender identity disorder; and
3. The goal of treatment is female-to-male gender reassignment.