Gender Dysphoria. Covered Services for Gender Dysphoria, a disorder characterized by diagnostic criteria classified in the current edition of the Diagnostic and Statistical Manual of the American Psychiatric Association, are provided if Prior Authorized and if the following diagnostic criteria are met: • A marked incongruence between the Insured’s experienced/expressed gender and the Insured’s assigned gender, of at least six months’ duration, as manifested by at least two of the following: o A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics). o A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics).
o A strong desire for the primary and/or secondary sex characteristics of the other gender.
o A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender). o A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender).
o A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender). • The condition is associated with clinically significant distress or impairment in social, occupational or other important areas of functioning. • A marked incongruence between the Insured’s experienced/expressed gender and assigned gender, of at least six months’ duration, as manifested by a strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender) and at least five of the following: o In boys (assigned gender), a strong preference for cross-dressing or simulating female attire; or in girls (assigned gender), a strong preference for wearing only typical masculine clothing and a strong resistance to the wearing of typical feminine clothing.
o A strong preference for cross-gender roles in make-believe play or fantasy play. o A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender. o A strong preference for playmates of the other gender. o In boys (assigned gender), a strong rejection of typically masculine toys, games and act...
Gender Dysphoria. Covered Services for Gender Dysphoria, a disorder characterized by diagnostic criteria classified in the current edition of the Diagnostic and Statistical Manual of the American Psychiatric Association, are provided if Prior Authorized and if the following diagnostic criteria are met: A marked incongruence between the Insured’s experienced/expressed gender and the Insured’s assigned gender, of at least six months’ duration, as manifested by at least two of the following:
