Policy: Gender Reassignment Surgery
Policy Number: CG-SURG-27
Last Update: 2021-05-13
Issued in: Louisiana

This policy applies to Medicaid

Youth Services:

A provider with experience treating adolescents with gender dysphoria may request further consideration of a bilateral mastectomy case in an individual under 18 years old when they meet all other bilateral mastectomy criteria above (including prior mental health evaluation) by contacting a Medical Director.  (Further information is available in the Discussion/General Information section of this document titled ‘Gender Reassignment Surgery in Individuals Under the Age of 18’).