TRICARE Gender Affirming Care Policy & Coverage 2026 | TRICARE.com

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## Quick answer TRICARE covers medical and psychological care for gender dysphoria, including hormone therapy and mental health counseling. However, by law, TRICARE does not cover gender-affirming surgery or any surgical procedures for the purpose of gender reassignment.

Details

TRICARE’s coverage for gender-affirming care is rooted in its definitions of "medically necessary" treatment and federal statutory limitations. While the policy has evolved to cover non-surgical treatments, surgical intervention remains a prohibited benefit for all TRICARE beneficiaries.

### Mental Health and Hormone Therapy TRICARE covers the following services when diagnosed with gender dysphoria: * **Psychotherapy:** Individual and group counseling is covered for all beneficiaries. * **Hormone Replacement Therapy (HRT):** Medications such as estrogen, testosterone, and puberty blockers are covered under the TRICARE Pharmacy Benefit, managed by Express Scripts. Standard 2026 pharmacy copayments apply (e.g., $18 for a 90-day supply of generics via mail-order). * **Laboratory Monitoring:** Blood work to monitor hormone levels and organ function is covered as a standard medical benefit.

### Surgical Exclusion Under Title 10, United States Code, Section 1079, federal law prohibits TRICARE from paying for "surgery which has the purpose of such a change [of sex]." This exclusion applies to all surgical procedures related to gender transition, including: * Mastectomy or "top surgery." * Phalloplasty or Vaginoplasty ("bottom surgery"). * Facial feminization surgery. * Tracheal shave or voice surgery.

These exclusions remain in place as of 2026 for all civilian beneficiaries and dependents.

### Active Duty Service Members (ADSMs) Active duty members may have additional options through the Military Hospitals and Clinics (MTFs). Under specific Department of Defense (DoD) policies, ADSMs may be eligible for a waiver or "Supplemental Care" that allows for certain surgical procedures to ensure medical readiness. This is managed through the member's branch of service and the Defense Health Agency (DHA), rather than the standard TRICARE civilian benefit. Effective Jan 1, 2025, **TriWest Healthcare Alliance** manages the West Region and **Humana Military** manages the East Region; these contractors facilitate civilian referrals, but they cannot authorize gender-affirming surgeries for dependents or retirees.

### Costs and Plan Specifics (2026) * **TRICARE Prime:** $0 copay for office visits at MTFs; standard specialty copays apply if referred to a civilian specialist. * **TRICARE Select:** Group A retirees typically pay a $39 copay for specialty office visits in 2026. * **Pharmacy:** Managed by Express Scripts. All FDA-approved hormones for gender dysphoria are covered, subject to standard tiered pricing.

## Who this affects * **Active Duty Service Members:** Eligible for therapy and hormones; may seek surgical care through DoD-specific waivers. * **Active Duty Family Members (ADFMs):** Eligible for therapy and hormones; surgeries are strictly excluded. * **Retirees and their families:** Eligible for therapy and hormones; surgeries are strictly excluded. * **National Guard and Reserve:** Eligible under TRICARE Reserve Select (TRS) for therapy and hormones. * **Survivors:** Eligible for therapy and hormones under standard plan rules.

## Sources * **TRICARE.mil:** [Gender Dysphoria Coverage Policy](https://www.tricare.mil/CoveredServices/IsItCovered/GenderDysphoria) * **Defense Health Agency (DHA):** [Health Care Program Policies](https://health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/TRICARE-Health-Plan) * **Humana Military (East Region):** [Provider Coverage Guidelines](https://www.humanamilitary.com/provider/education-and-resources/quick-access/policy-information/) * **TriWest Healthcare Alliance (West Region):** [Beneficiary Services and T-5 Information](https://www.triwest.com)