Medicaid and Affordable Care Act policies often do not cover permanent hair removal treatments for transgender patients, which could pose a barrier for gender-affirming care, according to a study published in JAMA Dermatology.

“Hair removal can be a vital component of the gender affirmation process for many transgender and gender minority individuals, as hormone therapy often does not adequately remove facial and body hair,” Nick Thoreson, BS, Boston University School of Medicine medical student and research student in the department of dermatology at Beth Israel Deaconess Medical Center, told Healio. “We wanted to examine the degree to which policies both public and private cover this aspect of gender affirmation care.”