Maryland Gov. Wes Moore signed the Trans Health Equity Act into law Wednesday, marking a culmination of efforts from Democratic lawmakers and advocates to ensure equal access to care.

The law — which requires Maryland Medicaid to expand its coverage of gender-affirming care — garnered support from Riley Grace Roshong, a dual law and public policy graduate student at the University of Maryland. Policymakers relied on Roshong’s research on gender-affirming care, which she did for her graduate capstone seminar, during the push for the bill’s passage this legislative session.

Roshong has been working on LGBTQ+ issues in Maryland for several years and was spurred to act by the growing number of bills aiming to restrict and ban gender-affirming care in state legislatures across the country, she said.

“I just wanted to see how much I could do as someone who’s a member of the community affected by this with the skills I’ve developed,” she said. “The goal was always to try and get stakeholders to consider these policy recommendations and the contents and the research that we developed.”

The Trans Health Equity Act failed to pass in the Maryland General Assembly’s 2022 legislative session, which Roshong said pushed her to focus on combating disinformation from opponents of the bill in an effort to ensure its passage in 2023.

[‘A small win’: Maryland advocates praise passage of bill expanding gender-affirming care]

Roshong used scientific evidence in her report to debunk talking points from opponents of the Trans Health Equity Act — including assertions that trans youth are not capable of giving informed consent and questions around whether being trans is an intrinsic quality.
The Trans Rights Advocacy Coalition, a group that Roshong worked with, was created to help pass the Trans Health Equity Act, according to coalition member Sam Williamson, who wrote the first draft of the bill.

Roshong’s research was combined with other work done by the Trans Rights Advocacy Coalition to create a document that advocates used to field questions from legislators and craft testimony, said Ericka McDonald, the parent of a transgender teenager who collaborated with Roshong. The document included information on the need for the Trans Health Equity Act, costs behind the bill and legal rulings in other states.

“Riley’s research, beyond the bill, is really groundbreaking because it lays the foundation for other states,” McDonald said.

Under the Trans Health Equity Act, Marylanders of all ages on Medicaid will have access to gender-affirming care. People under the age of 18 will be required by Maryland law to have parental consent, Williamson said.

Currently, Maryland Medicaid only covers mental health services for gender dysphoria, gender reassignment surgery and hormone replacement therapy. Starting in 2024, the program will also cover more treatments to align individuals’ physical appearances with their gender identity, including voice and hair alterations. Private insurances in Maryland already commonly covered these procedures.

In addition to her work on the act, Roshong was appointed to be a part of Moore’s transition team where she was able to advise the administration on LGBTQ+ policy.

[UMD Filipino community voices support for GWU nurse fired over unionization efforts]

She added a recommendation to the transition report that Maryland create a fund to increase training for medical professionals providing gender-affirming care over the coming years.

Moving forward, Roshong hopes Moore signs an executive order making Maryland a safe haven for people from other states to come and receive gender-affirming care. A lot of transgender people in states restricting gender-affirming care will have to move, she said.

“Maryland is primed to be one of the best states for people to go,” she said. “We are leading in the country.”

Some activists, including Williamson — who is also a staff attorney with Disability Rights Maryland — praised the Moore administration’s commitment to protecting the transgender community in the state.

In a speech before Moore signed the Trans Health Equity Act, Lt. Gov. Aruna Miller said all trans and nonbinary Marylanders deserved equal access to care.

“To all trans and nonbinary Marylanders, you deserve to be your authentic selves,” Miller said. “You deserve to live safely, openly and freely.”

Williamson hopes the passage of the Trans Health Equity Act will aid the passage of future bills protecting the rights of transgender Marylanders — including a bill that did not pass this legislative session that aimed to protect transgender, nonbinary and intersex inmates in Maryland’s prison facilities.

“I’m hoping that this will help build that foundation so that we can continue to protect the trans community,” they said.