The Seattle LGBT Commission has an effective way of talking about how some healthcare providers deny medical treatment related to transitioning. From The Slog:
When most of the city's approximately 10,000 employees seek mental health care, steroid treatments, or a variety of other services, they don't need to prove medical necessity to be covered under the city's employee benefits plan. But once an employee has been classified by the city's insurance carrier as transgender, those services are "universally denied," says the Seattle LGBT Commission in a letter to city officials. "First and foremost, transgender medical treatment is not cosmetic. It is necessary medical treatment. Psychological care, hormonal treatments, and surgical procedures are all medically necessary for transgender-identified individuals."
The Slog has quotes from several city officials, including the mayor, saying that they're looking into it.
While I'm a strong advocate of universal health care, guaranteed by the government either through nationalizing the health care system, creating a single payer system, or creating a highly regulated private/public health care system, this is one health care issue that can't just be solved by recognizing health care as a human right. That a progressive city like Seattle is still considering the issue while continuing to put that sort of medical care in a separate category to be denied, apart from other medical treatments that are assumed to be necessary until proven otherwise, shows that people have created an exemption for this care, either because of prejudice or a mistaken belief that it's merely cosmetic.
Still, going through a government body for health care produces statements like this instead of the more profitable "We'll never change" position a private insurer is enticed to take without pressure from large clients:
"This is a pretty modest issue compared to the significant issue we have of health care costs of the city as a whole," says [Mayor] McGinn. But he adds: "This is a fairness issue, it's not about costs."