'Erin In The Morning' is focused here only on federal law (not state laws), the main problem with which is: what constitutes necessary healthcare for someone who wants gender-affirming surgery. For example, if this is a rare newborn with both a vagina and a penis, the parents should have the option of getting insurance to pay for the advised gender-affirming survery (eg. is the newborn more male or more female). If however a 15-year-old wants to cut off his penis, that's not necessary. Most countries that have laws about gender-affirming care require that kid to reach age 18 before having the option to cut off his penis, or breasts, whichever. I am not sure about the laws in those countries about the necessity of this, and thus the insurance coverage for it. In the US, each state must decide on how they interpret this federal law about gender affirming surgery. A website that tracks this is: https://www.lgbtmap.org/equality-maps/medicaid