It seems like just another reason why health insurance should be decoupled from employment.
It's easy to use a case like this to say that insurance (employers, or whatever else) shouldn't be required to pay for something like this. The eternal question is where to draw lines. Some would say that "gender affirmation" surgery is elective, although some would say it's about putting the person into a body that works for them.
Ultimately wherever a line is drawn to differentiate elective processes from necessary processes there will be disagreement, exceptions, special cases etc.
In the early days of the ACA there was a big stink about employers who didn't want to be forced to fund abortions via their employees' health insurance plans. While it's easy to argue the case based on something as controversial as who funds abortions it raises the same question of where lines are drawn. If it's OK for a Christian employer to refuse to fund abortions, what about a Jehovah's Witness who refuses to fund blood transfusion? To what extent should an employer be permitted to determine what medical procedures their staff are allowed to access?
