Blue Cross Blue Shield of Georgia

Policy Number
CG-DRUG-61
Policy Issued In
Georgia
Last Update
Youth Services
  1. GnRH analogs are considered medically necessary for adolescents with gender dysphoria when all of the following criteria are met: 
    1. Fulfills the DSM V criteria for gender dysphoria; and 
    2. Has experienced puberty to at least Tanner stage 2; and 
    3. Has (early) pubertal changes that have resulted in an increase of their gender dysphoria; and 
    4. Does not suffer from a psychiatric comorbidity that interferes with the diagnostic work-up or treatment; and 
    5. Has psychological and social support during treatment; and 
    6. Demonstrates knowledge and understanding of the expected outcomes of GnRH analog treatment.