HONOLULU (HawaiiNewsNow) - Four years ago, fashion designer Andy South became Ariyaphon Southiphong and started hormone replacement therapy.
Convincing her health insurance to cover transgender specific treatments was a challenge.
"When it comes down to medical things, that's where I felt the most heartache and the most struggle," Southiphong said.
A measure moving through the state Legislature would address the issue, prohibiting health insurance companies from deciding whether a procedure is covered based on a person's actual or perceived gender identity.
Rebecca Copeland, of Equality Hawaii, said many of the state's 15,000 transgenders are denied insurance coverage for a variety of treatments.
"Wellness checkups, emergency care and a lot of things you and I take for granted. They're being denied that on the basis of gender identity," she said.
But state Rep. Bob McDermott, whose district includes Ewa and Ewa Beach, believes the bill is an overreach and attempts to re-define gender.
"If I put a wig and high heels on and I want to go get a Pap smear, the doctor has to affirm my fantasy, the way the law is written, and go along with this for me because 'all the other girls' are getting it done," he said.
HMSA, Hawaii's largest health insurer, offers a gender reassignment policy under its plan for federal employees. In testimony, HMSA said the measure seeks to "ensure access to current benefits provided in a plan rather than an expansion of benefits."
Copeland agreed, saying the bill is about ensuring equal access to health care.
"Obviously, the bill helps a particular segment. It helps transgender people. But it's about medical care. It's about getting services," Copeland said.
Other states have passed similar measures and proponents say they have not translated into higher health care costs.
For her part, Southiphong said the bill is a "starting point."
"There's a lot more that has to be done," she said.
Southiphong's medical insurer does pay for hormone replacement therapy. Without coverage, the monthly bill would be up to $300 per treatment.