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.
FAQs About HB 2002 Related to Gender-Affirming Treatment
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To whom does HB 2002 apply?
- HB 2002 is applicable to adults and minors 15 and older.
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Does HB 2002 change parental consent laws for minors?
- No. Oregon law already allows minors 15 and older to consent to their own medical care, including gender-affirming treatment, without parental permission.
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Does HB 2002 require insurance coverage for gender-affirming care?
- Generally, yes. It ensures coverage of all medically necessary gender-affirming care services in commercial insurance, the Oregon Health Plan, and public employee health plans.
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How does HB 2002 protect gender-affirming health care providers?
- The law may protect gender-affirming health care providers' names and addresses located in public records from disclosure.
The law also allows a gender-affirming health care provider to participate in the Oregon Department of Justice’s Address Confidentiality Program».
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What protections does HB 2002 provide against out-of-state laws?
- The law provides that out-of-state laws allowing civil or criminal actions against persons who receive, provide, or assist other persons in receiving gender-affirming treatment are contrary to policies in our state.
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What does HB 2002 say about malpractice insurance related to other state’s restrictions on access to gender-affirming care?
- The law prevents consequences to Oregon health care providers’ malpractice insurance related to other state laws restricting access to gender-affirming care.
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Where can I find read the full text of HB 2002?
- You can read it here: HB2002.
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 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 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 ensure there are enough providers nearby so that people can get gender-affirming treatment easily and timely. The law requires carriers to 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 (not covered) 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 (covered) provider.
Additionally, 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 also meet these requirements.
The Department of Consumer and Business Services is responsible for enforcing these provisions of the shield law with respect to carriers and has adopted rules for enforcement.
References: ORS 743A.325 » and OAR 836-053-0441 ». See also ORS 243.144 and ORS 243.877 ».
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Does the Oregon Health Plan pay for gender-affirming treatment?
- Generally, yes for individuals on the Oregon Health Plan (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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• Health Care Provider Confidentiality
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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” meaning sometimes the information can be kept private 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 (ACP) administered by the Oregon Department of Justice.
The Address Confidentiality Program (ACP) is run by the Crime Victims and Survivor Services Division, but protected practitioners do not have to be crime victims to participate in ACP. Protected practitioners can participate by virtue of being a “health care provider,” defined as “an individual who is authorized in this state to provide physical and behavioral health care services and who provides reproductive and gender-affirming health care services.”
References: ORS 192.345(43), ORS 192.820, ORS 192.820(4), ORS 192.822(1), ORS 192.826(8) », and OAR Ch. 137, Div. 79 ».
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• Providing Care in Another State
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What action may an Oregon health professional regulatory board take with respect to practitioners who provide 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) ».
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• Prohibition on Regulator Boards Sharing Information with Other States
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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) ».
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• Actions by Malpractice Insurers
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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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• Application of Other State’s Laws to Oregon
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Will Oregon enforce the laws of other states about gender-affirming treatment when those other state laws are contrary to Oregon public policy?
No, 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 ».
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• Out-of-State Subpoenas
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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 an out-of-state subpoena is directed if the out-of-state subpoena relates to gender-affirming treatment that is permitted under Oregon law, unless the person requesting the subpoena provides a written declaration that the out-of-state subpoena relates to:
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- 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
- 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 ».
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• Enforcement of Other States’ Civil Laws
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Can a person in Oregon 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 applies to civil cases about gender-affirming treatment provided in Oregon, if the case in not based on a contract. This protection covers healthcare providers, patients, and anyone who helped support the treatment.
Reference: ORS 15.430 ».
Legal Action Around Gender-Affirming Treatment
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.
Public School Resources
ODE-Gender-Affirming-Care-Resources »
ODE-Supporting-Gender-Expansive-Students »
LGBTQ2SIA+ Resources: State of Oregon »
Oregon and Nationally Based Resources
TransPonder (Oregon) »
Black & Beyond the Binary Collective (Oregon) »
2SLGBTQ+ Services – NARA NW (Oregon) »
American Civil Liberties Union »
Black / African American Community – PFLAG »
Hotline – Trans Lifeline »
Black Trans Advocacy Coalition »
TransLatin@ Coalition »
The Okra Project »
NWGA »
Home – Transgender Law Center »
Transgender American Veterans Association »
National Center for Transgender Equality »
Healthcare Resources
Oregon Health Authority: Gender-Affirming Care for Oregon Health Plan (OHP) Members: »
Care Oregon – Gender-affirming care »
Finding a Provider
Patient Guide to Gender-Affirming Care | OHSU »
Gender care | Legacy Health »
Gender Affirming Hormone Care | Planned Parenthood Columbia Willamette »
Gender Affirming Care | Planned Parenthood of Southwestern Oregon »
OregonHealthCare.gov: Find local help: State of Oregon »