Even before President Donald Trump took office, transgender patients in Hawaiʻi were struggling to get insurance to cover some treatments. Now it’s getting worse.

After coming out as transgender to her therapist and her wife in 2023, one of Geena Thielen’s first priorities was to get rid of her facial hair.

The affordable housing developer began hair removal treatments, some of which were covered by her health insurance plan through the Hawaii Medical Service Association.

But in February 2024, HMSA started to deny her laser treatments, stating in letters to Thielen that the procedure doesn’t fall under the company’s “Medical Policy for Gender Identity Services.” Thielen’s hair removal was not medically necessary, the insurer said, even though Thielen’s dermatologist and therapist both d

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