{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3449.1.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3449.1.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3449.1.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3449.1.html"}],"law_id":67706,"edition_id":1,"section_id":67706,"structure_id":13819,"section_number":"38.2-3449.1","catch_line":"Prohibited discrimination based on gender identity or status as a transgender individual","history":"2020, c. 844.","full_text":"A\n\nAs used in this section:\n\t\t\t“Gender identity” means an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female and which may be different from an individual’s sex assigned at birth.\n\t\t\t“Medically necessary transition-related care” means any medical treatment prescribed by a licensed physician for treatment of gender dysphoria and includes (i) outpatient psychotherapy and mental health services for gender dysphoria and associated co-morbid psychiatric diagnoses; (ii) continuous hormone replacement therapy; (iii) outpatient laboratory testing to monitor continuous hormone therapy; and (iv) gender reassignment surgeries.\n\t\t\t“Transgender individual” means an individual whose gender identity is different from the sex assigned to that individual at birth.B\n\nA health carrier offering a health benefit plan providing individual or group health insurance coverage shall:1\n\nProvide coverage under the health benefit plan without discrimination on the basis of gender identity or status as a transgender individual; and2\n\nTreat covered individuals consistent with their gender identity.C\n\nA health carrier offering a health benefit plan providing individual or group health insurance coverage shall not deny or limit coverage or impose additional cost sharing or other limitations or restrictions on coverage, under a health benefit plan for health care services that are ordinarily or exclusively available to covered individuals of one sex, to a transgender individual on the basis of the fact that the individual’s sex assigned at birth, gender identity, or gender otherwise recorded is different from the one to which such health services are ordinarily or exclusively available.D\n\nAn individual shall not be subjected to discrimination under a health benefit plan on the basis of gender identity or being a transgender individual, including by being denied coverage of medically necessary transition-related care.E\n\nNothing in this section is intended to determine, or restrict a health carrier from determining, whether a particular health care service is medically necessary or otherwise meets applicable coverage requirements in any individual case.F\n\nA health carrier shall not require any individual, as a condition of enrollment or continued enrollment under a health benefit plan, to pay a premium or contribution that is greater than such premium or contribution for a similarly situated covered person enrolled in the plan on the basis of the covered person’s gender identity or being a transgender individual.G\n\nHealth carriers shall assess medical necessity according to nondiscriminatory criteria that are consistent with current medical standards.","order_by":null,"text":{"0":{"id":245247,"text":"As used in this section:\n\t\t\t“Gender identity” means an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female and which may be different from an individual’s sex assigned at birth.\n\t\t\t“Medically necessary transition-related care” means any medical treatment prescribed by a licensed physician for treatment of gender dysphoria and includes (i) outpatient psychotherapy and mental health services for gender dysphoria and associated co-morbid psychiatric diagnoses; (ii) continuous hormone replacement therapy; (iii) outpatient laboratory testing to monitor continuous hormone therapy; and (iv) gender reassignment surgeries.\n\t\t\t“Transgender individual” means an individual whose gender identity is different from the sex assigned to that individual at birth.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":245248,"text":"A health carrier offering a health benefit plan providing individual or group health insurance coverage shall:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":245249,"text":"Provide coverage under the health benefit plan without discrimination on the basis of gender identity or status as a transgender individual; and","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":245250,"text":"Treat covered individuals consistent with their gender identity.","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"C"},"4":{"id":245251,"text":"A health carrier offering a health benefit plan providing individual or group health insurance coverage shall not deny or limit coverage or impose additional cost sharing or other limitations or restrictions on coverage, under a health benefit plan for health care services that are ordinarily or exclusively available to covered individuals of one sex, to a transgender individual on the basis of the fact that the individual’s sex assigned at birth, gender identity, or gender otherwise recorded is different from the one to which such health services are ordinarily or exclusively available.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B2","next_prefix":"D"},"5":{"id":245252,"text":"An individual shall not be subjected to discrimination under a health benefit plan on the basis of gender identity or being a transgender individual, including by being denied coverage of medically necessary transition-related care.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"6":{"id":245253,"text":"Nothing in this section is intended to determine, or restrict a health carrier from determining, whether a particular health care service is medically necessary or otherwise meets applicable coverage requirements in any individual case.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"7":{"id":245254,"text":"A health carrier shall not require any individual, as a condition of enrollment or continued enrollment under a health benefit plan, to pay a premium or contribution that is greater than such premium or contribution for a similarly situated covered person enrolled in the plan on the basis of the covered person’s gender identity or being a transgender individual.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"8":{"id":245255,"text":"Health carriers shall assess medical necessity according to nondiscriminatory criteria that are consistent with current medical standards.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F"}},"ancestry":[{"id":13819,"edition_id":1,"name":"Federal Market Reforms","identifier":"6","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:45:59","date_modified":"2026-06-26 03:45:59","permalink":{"id":215457,"object_type":"structure","relational_id":13819,"identifier":"6","token":"38.2\/34\/6","url":"\/38.2\/34\/6\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":57210,"structure_id":13819,"section_number":"38.2-3438","catch_line":"Definitions","url":"\/38.2-3438\/","token":"38.2\/34\/6\/38.2-3438","metadata":false},{"id":55902,"structure_id":13819,"section_number":"38.2-3439","catch_line":"Dependent coverage for individuals to age 26","url":"\/38.2-3439\/","token":"38.2\/34\/6\/38.2-3439","metadata":false},{"id":59514,"structure_id":13819,"section_number":"38.2-3440","catch_line":"Lifetime and annual limits","url":"\/38.2-3440\/","token":"38.2\/34\/6\/38.2-3440","metadata":false},{"id":74720,"structure_id":13819,"section_number":"38.2-3441","catch_line":"Rescissions","url":"\/38.2-3441\/","token":"38.2\/34\/6\/38.2-3441","metadata":false},{"id":81548,"structure_id":13819,"section_number":"38.2-3442","catch_line":"Preventive 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This law was first created in 2020. The record of its establishment is cataloged in chapter 844<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year.<\/p>","references":false,"refers_to":false,"permalink":{"id":215543,"object_type":"law","relational_id":67706,"identifier":"38.2-3449.1","token":"38.2\/34\/6\/38.2-3449.1","url":"\/38.2-3449.1\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3449.1\/","token":"38.2\/34\/6\/38.2-3449.1","dublin_core":{"Title":"Prohibited discrimination based on gender identity or status as a transgender individual","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3449.1","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> As used in this section:\n\t\t\t“Gender identity<\/span>” means an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female and which may be different from an individual’s sex assigned at birth.\n\t\t\t“Medically necessary transition-related care<\/span>” means any medical treatment prescribed by a licensed physician for treatment of gender dysphoria and includes (i) outpatient psychotherapy and mental health services for gender dysphoria and associated co-morbid psychiatric diagnoses; (ii) continuous hormone replacement therapy; (iii) outpatient laboratory testing to monitor continuous hormone therapy; and (iv) gender reassignment surgeries.\n\t\t\t“Transgender individual<\/span>” means an individual whose gender identity<\/span> is different from the sex assigned to that individual at birth. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> A health carrier offering a health benefit plan providing individual or group health insurance<\/span> coverage shall: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Provide coverage under the health benefit plan without discrimination on the basis of gender identity<\/span> or status as a transgender individual<\/span>; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Treat covered individuals consistent with their gender identity<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> A health carrier offering a health benefit plan providing individual or group health insurance<\/span> coverage shall not deny or limit coverage or impose additional cost sharing or other limitations or restrictions on coverage, under a health benefit plan for health care services that are ordinarily or exclusively available to covered individuals of one sex, to a transgender individual<\/span> on the basis of the fact<\/span> that the individual’s sex assigned at birth, gender identity<\/span>, or gender otherwise recorded is different from the one to which such health services are ordinarily or exclusively available. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> An individual shall not be subjected to discrimination under a health benefit plan on the basis of gender identity<\/span> or being a transgender individual<\/span>, including by being denied coverage of medically necessary transition-related care<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Nothing in this section is intended to determine, or restrict a health carrier from determining, whether a particular health care service is medically necessary or otherwise meets applicable coverage requirements in any individual case. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> A health carrier shall not require any individual, as a condition of enrollment or continued enrollment under a health benefit plan, to pay a premium or contribution that is greater than such premium or contribution for a similarly situated covered person<\/span> enrolled in the plan on the basis of the covered person<\/span>’s gender identity<\/span> or being a transgender individual<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> Health carriers shall assess medical necessity according to nondiscriminatory criteria that are consistent with current medical standards. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPROHIBITED DISCRIMINATION BASED ON GENDER IDENTITY OR STATUS AS A TRANSGENDER\nINDIVIDUAL (\u00a7 38.2-3449.1)\n\nA. As used in this section:\n\t\t\t“Gender identity” means an individual’s internal sense of\ngender, which may be male, female, neither, or a combination of male and female\nand which may be different from an individual’s sex assigned at birth.\n\t\t\t“Medically necessary transition-related care” means any medical\ntreatment prescribed by a licensed physician for treatment of gender dysphoria\nand includes (i) outpatient psychotherapy and mental health services for gender\ndysphoria and associated co-morbid psychiatric diagnoses; (ii) continuous\nhormone replacement therapy; (iii) outpatient laboratory testing to monitor\ncontinuous hormone therapy; and (iv) gender reassignment surgeries.\n\t\t\t“Transgender individual” means an individual whose gender\nidentity is different from the sex assigned to that individual at birth.\n\nB. A health carrier offering a health benefit plan providing individual or group\nhealth insurance coverage shall:\n\n 1. Provide coverage under the health benefit plan without discrimination on\n the basis of gender identity or status as a transgender individual; and\n\n 2. Treat covered individuals consistent with their gender identity.\n\nC. A health carrier offering a health benefit plan providing individual or group\nhealth insurance coverage shall not deny or limit coverage or impose additional\ncost sharing or other limitations or restrictions on coverage, under a health\nbenefit plan for health care services that are ordinarily or exclusively\navailable to covered individuals of one sex, to a transgender individual on the\nbasis of the fact that the individual’s sex assigned at birth, gender\nidentity, or gender otherwise recorded is different from the one to which such\nhealth services are ordinarily or exclusively available.\n\nD. An individual shall not be subjected to discrimination under a health benefit\nplan on the basis of gender identity or being a transgender individual,\nincluding by being denied coverage of medically necessary transition-related\ncare.\n\nE. Nothing in this section is intended to determine, or restrict a health\ncarrier from determining, whether a particular health care service is medically\nnecessary or otherwise meets applicable coverage requirements in any individual\ncase.\n\nF. A health carrier shall not require any individual, as a condition of\nenrollment or continued enrollment under a health benefit plan, to pay a premium\nor contribution that is greater than such premium or contribution for a\nsimilarly situated covered person enrolled in the plan on the basis of the\ncovered person’s gender identity or being a transgender individual.\n\nG. Health carriers shall assess medical necessity according to nondiscriminatory\ncriteria that are consistent with current medical standards.\n\nHISTORY: 2020, c. 844.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}