Gender Diverse Community Resources

What Does Oregon Law Say About Gender-Affirming Treatment and Care?

Oregon Shield Law and Related Protections FAQs

In 2023, the Oregon Legislature enacted HB 2002 (OL 2023 ch. 228), sometimes referred to as a “shield law” », which contains numerous protections for gender-affirming care and Oregon health care professionals who provide it. Below, key portions of the shield law are summarized and described. Please note that this information is not a substitute for legal advice; if you require legal advice, please consult an attorney. This information is current as of 2/12/2025.

Topic: Health Insurance

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Do health insurance plans in Oregon have to cover gender-affirming treatment?

Generally, yes. The shield law prohibits carriers who provide health benefit plans in Oregon from denying or limiting coverage for gender-affirming treatment that is medically necessary (as determined by the physical or behavioral health provider who prescribes the treatment) and prescribed in accordance with accepted standards of care.

Carriers are prohibited from applying categorical cosmetic or blanket exclusions to medically necessary gender-affirming treatment and from excluding as a “cosmetic service” procedures that are medically necessary as part of an individual’s gender-affirming treatment, including tracheal shaves, hair electrolysis, facial feminization surgery or other facial gender-affirming treatment, revisions to prior forms of gender-affirming treatment, or any combination of such services.

Carriers are also prohibited from issuing an adverse benefit determination denying or limiting access to gender-affirming treatment unless a physical or behavioral health care provider with experience prescribing or delivering gender-affirming treatment has first reviewed and approved the denial of or the limitation on access to the treatment.

Under the shield law, carriers are required to satisfy applicable network adequacy standards related to gender-affirming treatment providers; and either:

contract with a network of gender-affirming treatment providers that is sufficient in numbers and geographic locations to ensure that gender-affirming treatment services are accessible to all enrollees without unreasonable delay; or
ensure that all enrollees have geographical access without unreasonable delay to out-of-network gender-affirming treatment services with cost-sharing or other out-of-pocket costs for the services no greater than the cost-sharing or other out-of-pocket costs for the services when furnished by an in-network provider.

Benefit plans offered by the Public Employees’ Benefit Board or Oregon Educators Benefit Board which reimburse the costs of medical and other health services must meet these requirements.

The Department of Consumer and Business Services is responsible to enforce these provisions of the shield law with respect to carriers and has adopted rules.

References: ORS 743A.325 » and OAR 836-053-0441 ». See also ORS 243.144 and ORS 243.877 ».

Does the Oregon Health Plan pay for gender-affirming treatment?

Generally, yes for individuals on the Oregon Health Plan (that is, whose health care is paid for by the Oregon Health Authority (OHA), whether it is paid for directly by OHA or through a coordinated care organization or CCO). Under the shield law, those organizations are prohibited from denying or limiting coverage for gender-affirming treatment that is medically necessary (as determined by the physical or behavioral health provider who prescribes the treatment) and prescribed in accordance with accepted standards of care. They are also prohibited from denying as a “cosmetic service” procedures that are medically necessary as part of an individual’s gender-affirming treatment, including tracheal shaves, hair electrolysis, facial feminization surgery or other facial gender-affirming treatment, revisions to prior forms of gender-affirming treatment, or any combination of such services.

Under the shield law, CCOs are required to contract with a network of gender-affirming treatment providers that is sufficient in numbers and geographic locations to meet applicable network adequacy standards and either: 1) ensure that gender-affirming treatment services are accessible to all of the CCO’s members without unreasonable delay; or 2) ensure that all members have geographical access to non-contracting providers of gender-affirming treatment services without unreasonable delay.

The Oregon Health Authority is responsible to monitor CCOs for compliance with these provisions.

Reference: ORS 414.769 », Oregon Health Plan/Prioritized List of Health Services ».

Topic: Oregon Health Care Providers

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What protections are there for the confidentiality of Oregon health care providers who provide gender-affirming health care services?

There are two forms of protection under the shield law. First, the name, home address, professional address or location of an individual who is authorized to provide physical and behavioral health care services in Oregon and who provides gender-affirming health care services is “conditionally exempt” from disclosure under the Oregon Public Records Law when the information is in the possession of a public body.

Second, individuals who are authorized to practice in Oregon to provide physical and behavioral health care services and who provide gender-affirming health care services may be eligible to participate in the Address Confidentiality Program administered by the Oregon Department of Justice.

References: ORS 192.345(43), ORS 192.820(4). ORS 192.822(1), ORS 192.826(8) », and OAR Ch. 137, Div. 79 ».

What action may an Oregon health professional regulatory board take with respect to a licensee, registrant, permittee, or other authorized practitioner for providing gender-affirming health care in another state?

Generally, none. Under the shield law, the following regulatory boards are prohibited from suspending, revoking, or refusing to grant licenses to practice because of a person’s conviction, license revocation, or license suspension based solely upon the provision of gender-affirming care services that are lawful in Oregon and were performed in accordance with the applicable standard of care, although they were performed in a jurisdiction where the care was unlawful:

Oregon Board of Psychology
State Board of Licensed Social Workers
Oregon Board of Licensed Professional Counselors and Therapists
Oregon Medical Board
Oregon State Board of Nursing
Oregon Board of Naturopathic Medicine
State Board of Pharmacy

References: ORS 675.070(7), ORS 675.540(8), ORS 675.745(8) », ORS 677.190(6), ORS 677.225 », ORS 678.138 », ORS 685.110(7) and (18) », and ORS 689.405(3)(j) and (4) ».

What investigatory information may an Oregon health professional regulatory board share with other public entities, including regulatory or licensing boards in other states, about gender-affirming care?

None. Under the shield law, an Oregon health professional regulatory board is not permitted to disclose confidential investigatory information related to another public entity’s regulatory or enforcement authority if the information relates to the provision of or referral for gender-affirming health care services.

Reference: ORS 676.177(5) ».

May a malpractice insurer take adverse action in Oregon against a provider who provides gender- affirming health care?

Generally, no. The shield law created important restrictions on adverse actions that a malpractice insurer can take. “Adverse action” for purposes of the shield law is defined to include but not be limited to sanctions, fines, penalties, rate increases or denial or revocation of coverage.

Specifically, an insurer that provides malpractice insurance for a health care provider for care provided in Oregon may not take adverse action, against a health care provider authorized to provide care in Oregon if the adverse action is:

Based solely on the health care provider’s providing, authorizing, recommending, aiding, assisting, referring for or otherwise participating in a gender-affirming health care service that is lawful in Oregon but unlawful in the jurisdiction in which the health care provider provided the service, so long as the service provided was performed in accordance with the standard of care applicable to the service; or
A result of an adverse action taken against the health care provider’s license issued by another state that resulted solely from the health care provider’s providing, authorizing, recommending, aiding, assisting, referring for or otherwise participating in a gender-affirming health care service that is lawful in Oregon but provided to a resident of a jurisdiction in which the service is unlawful or is unlawful in the jurisdiction in which the health care provider provided the service, so long as the service provided was performed in accordance with the standard of care applicable to the service.

Reference: ORS 676.313 ».

Topic: Legal Actions from Other States or Based on the Laws of Other States

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What is Oregon’s position about laws of other states which authorize a person to bring a civil or criminal action against a person who receives, provides, or assists another person to provide or receive gender-affirming treatment?

The Oregon legislature has found that such laws are “contrary to the public policy of this state.” Specifically, laws of other states are contrary to the public policy of Oregon if they authorize a person to bring civil or criminal action against another person who:

Receives gender-affirming treatment;
Provides or attempts to provide gender-affirming treatment; or
Knowingly engages in conduct that aids or abets the provision of gender-affirming treatment.

Reference: ORS 24.500 ».

Can a person from another state ask an Oregon state court to issue a subpoena to serve an out-of-state subpoena related to gender-affirming treatment?

No, under the shield law, a person cannot request that a clerk of an Oregon state court issue a subpoena for service upon a person to whom a foreign subpoena is directed if the foreign subpoena relates to gender-affirming treatment that is permitted under Oregon law, unless the person requesting the subpoena provides a written declaration that the foreign subpoena relates to:

1. An out-of-state action founded in tort, contract or statute, for which a similar claim would exist under Oregon law, brought by a patient or the patient’s authorized legal representative, for damages suffered by the patient; or
2. An out-of-state action founded in contract, and for which a similar claim would exist under Oregon law, brought or sought to be enforced by a party with a contractual relationship with the person that is the subject of the subpoena.

Reference: ORS 24.500 ».

Can someone use the civil law of another state against someone who received, provided or assisted in gender-affirming treatment in Oregon?

No, under the shield law, Oregon law governs noncontractual civil law claims about gender-affirming treatment provided in Oregon, whether those actions are brought against a provider of gender-affirming treatment, a patient who received gender-affirming treatment, or any person who provided “aid, assistance, resources or support” to a person who provided or received gender-affirming treatment in Oregon.

Reference: ORS 15.430 ».

Legal Action Around Gender Identity

Learn more about the Oregon Department of Justice’s legal action to defend Oregon values here.
AG Dan Rayfield Files Lawsuit

Resources and Healthcare Protections

Below is a list of resources for the transgender and gender diverse Oregonians and those working with and supporting these communities.

What Does Oregon Law Say About Gender-Affirming Treatment and Care?

Oregon Shield Law and Related Protections FAQs

Topic: Health Insurance

Topic: Oregon Health Care Providers

Topic: Legal Actions from Other States or Based on the Laws of Other States

Legal Action Around Gender Identity

Resources and Healthcare Protections

School Resources

Community Based Resources

Healthcare Resources

Finding a Provider