Gender-affirming surgery and fertility care for adults, in Medellín
New US rules let many plans drop gender-affirming surgery starting in 2026, and fertility coverage depends on your employer and your state. Here's what changed, what Colombian law says, and how to get a written quote. For adults 18 and over.
What changed in US coverage
Three changes matter most for 2026:
Federal employees (FEHB)
For plan year 2026, FEHB plans no longer cover surgical or chemical modification of sex traits. There's an exceptions process for people mid-treatment, and counseling stays covered (OPM).
ACA marketplace plans
Starting in plan year 2026, individual and small-group plans can't cover specified sex-trait modification procedures as an essential health benefit. Plans may still cover them outside that package (CMS).
Medicaid
16 states and 2 territories exclude coverage of transgender-related care, while 28 states and DC explicitly cover it (Movement Advancement Project, July 2026).
Rules change. Check your own plan's documents, or call the number on your card, before you decide.
What Colombian law says
For Colombian citizens, changing the gender marker on official records takes a sworn statement, and authorities can't demand any additional documents or proof (Decreto 1227 de 2015). In October 2025, Colombia's Constitutional Court held that a gender dysphoria diagnosis isn't required for gender-affirming surgery within the public health system (T-436/25).
Those rules apply to Colombia's own health system. If you're paying a private surgeon, the surgeon sets the requirements, such as evaluations or letters. Ask for them in writing with your quote.
Fertility care: what to know
Colombia's infertility law sets public policy for treating an infertile couple, "pareja infértil" (Ley 1953 de 2019). We haven't found any Colombian law or ruling that expressly allows or bars IVF for single women or same-sex couples, and the Constitutional Court has described a legal gap on assisted reproduction (SU-074/20). Each clinic sets its own policy, so ask before you send records.
If your child is born in Colombia, the Constitutional Court has held that the civil registry can list two mothers or two fathers (SU-696/15; T-105/20). How your home country recognizes that is a question for a lawyer there.
Surrogacy in Colombia isn't regulated, and a bill to criminalize it was filed in August 2026 (Publimetro). This page doesn't cover surrogacy.
For IVF costs and how a quote works, see IVF without insurance coverage.
How a quote works
Tell us what you need
Only what you're comfortable sharing. WhatsApp is fine.
Get a written plan
A Medellín surgeon or fertility clinic replies with its requirements, an itemized plan and a price.
Ask anything
Ask about requirements, recovery time and follow-up before you agree to anything.
Keep your records
Bring every report and invoice home for your doctor there.
Questions
Is this for minors?
No. This page and these services are for adults 18 and over only.
Will my US plan pay for surgery in Colombia?
Don't count on it. Many plans are dropping this coverage in 2026. Check your plan documents, including whether the plan pays providers outside the US.
Do I need a letter or a diagnosis?
A private surgeon sets their own requirements. Ask for them in writing before you book.
Will Colombian fertility clinics treat single women and same-sex couples?
Colombian law doesn't expressly address it either way, so each clinic sets its own policy. We'll ask before you send records.
Will my information stay private?
We share your request only with the clinics you agree to (up to 3), so they can contact you. See our privacy policy.
How does ColombiaMedical make money?
Clinics in our network may pay us a referral fee. Requesting a quote is free for you, with no obligation.
Get a free, private quote
Share only what you're comfortable with. A Medellín clinic will reply with questions or a written quote. It's free, with no obligation.
Prefer to message? WhatsApp Andy directly.
WhatsApp +1 614 607 1230Sources
- FEHB Carrier Letter 2025-01b (U.S. Office of Personnel Management, Aug. 15, 2025)
- 2025 Marketplace Integrity and Affordability final rule fact sheet (CMS, June 20, 2025)
- Medicaid coverage of transgender-related health care (Movement Advancement Project, updated July 13, 2026)
- Decreto 1227 de 2015 (República de Colombia)
- Sentencia T-436/25 (Corte Constitucional de Colombia, Oct. 22, 2025)
- Ley 1953 de 2019 (Supersalud normograma)
- Sentencia SU-074/20 (Corte Constitucional de Colombia, Feb. 20, 2020)
- Comunicado, Sentencia SU-696/15 (Corte Constitucional de Colombia, Nov. 12, 2015)
- Sentencia T-105/20 (Corte Constitucional de Colombia, Mar. 12, 2020)
- Presentan proyecto de ley contra vientres de alquiler (Publimetro Colombia, Aug. 21, 2026)
Last checked October 5, 2026. Rules and figures change; confirm anything that affects your money or care with the agency directly.