Policy: Testosterone Androgens
Policy Number: I-145-007
Last Update: 2020-02-17
Issued in: Pennsylvania

Youth Services:

Testosterone injections may be considered medically necessary for transgender individuals who meet ALL the following:

• Individual is 14 years of age or older; and
• Individual has a diagnosis of gender dysphoria or gender identity disorder; and
• The goal of treatment is masculinization.