If you’re a New Yorker who is dissatisfied with the original set of chromosomes you were dealt at birth, good news is on the way. Historically, various types of reassignment surgeries involved in switching genders have been considered to be either cosmetic or optional by insurance companies and have generally not been covered. These procedures are not cheap, so they remained beyond the reach of a lot of people. But now, Governor Andrew Cuomo has sent a letter to insurers in the Empire State letting them know that they are going to have to start footing the bill.

Now Gov. Andrew M. Cuomo is warning insurance companies that they will no longer be allowed to deny gender reassignment surgery or other treatment to change a person’s gender, like hormone therapy, if a doctor has deemed that treatment medically necessary.

In a letter being sent to insurance companies this week, the governor said that because state law requires insurance coverage for the diagnosis and treatment of psychological disorders, people who are found to have a mismatch between their birth sex and their internal sense of gender are entitled to insurance coverage for treatments related to that condition, called gender dysphoria.

“An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria,” the governor’s letter says.

I have to wonder if anyone is going to challenge this – assuming you could find somebody with standing to challenge it – because there doesn’t seem to be any sort of new legislation or even updated industry regulation taking place here. This is essentially just the Governor and his staff taking an existing law and writing a letter containing a brand new interpretation of it to the insurance companies.

As to the inevitable question of who pays for this, I suppose everyone will. If gender dysphoria is being lumped in with the general pool of covered maladies, then the insurance companies will raise their rates for everyone to account for the increase in costs. But as one industry spokesperson mentions in the article, we’re talking about such a small sliver of the population that the overall effect may be negligible. If that’s the case, I suppose I’m not going to be raising any major objections here as long as the procedures are only being performed on adults. I tend to take a very libertarian approach to such things, and what you do with your own body after the age of eighteen is pretty much your own choice, provided you’re willing to accept responsibility for any potential problems which it generates further down the line.

And there are clearly dangers to take into consideration. Long term hormone therapy, for example, requires very stringent oversight by medical professionals and can present serious complications even for those who are forced into it by menopause, early age hysterectomies or diseases forcing the the removal of various hormone producing organs. Surgeries, such as the mastectomy mentioned in the linked article, are also serious, invasive events and should never be entered into without careful consideration. (Because no surgery is without risk, including relatively “simple” ones which are done every day around the world.)

But if a person wants to do this and is willing to deal with the repercussions, that’s their call in my opinion. Should the rest of the population pay higher premiums on their medical insurance to cover them? That’s a separate issue.