很多蓝州州cover 变性，为啥这么多； 如果不付一下就少很多

many blue (Democratic-leaning) states in the U.S. do cover sex reassignment (gender-affirming) treatments for low-income individuals under their state Medicaid programs. However, coverage and scope vary by state.

Here’s a breakdown:

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Blue States That Cover Gender-Affirming Care under Medicaid

These states explicitly cover procedures such as:

• Hormone therapy

• Mental health services

• Gender-affirming surgeries (e.g., top and bottom surgery, facial feminization in some cases)

Examples:

State	Medicaid Coverage for Sex Transition (as of 2025)
California	Full coverage (one of the most comprehensive)
New York	Covers HRT and surgeries
Oregon	Covers most procedures, including facial surgery
Washington	Covers HRT, surgeries, counseling
Colorado	Explicitly includes gender-affirming care since 2021
Massachusetts	Comprehensive coverage
Illinois	Added coverage in 2019 for gender-affirming surgeries
Vermont	Strong support; covers surgery and hormones

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