This letter (available here) reminds Medi-Cal Managed Care Plans to communicate to its provider networks and subcontractors the requirement that transgender services (including psychotherapy, continuous hormone therapy, laboratory testing to monitor hormone therapy and gender reassignment surgery that is not cosmetic in nature) be made available to Medi-Cal beneficiaries. Criteria for medical necessity is based on the most current WPATH “Standards of Care for Health of Transsexual, Transgender, and Gender Nonconforming People.”