NEW YORK (CBSNewYork) – Gov. Andrew Cuomo moved Wednesday to provide Medicaid support for hormone therapy and gender reassignment surgery, among other health care services, for transgender people.

Continuing his legacy as an advocate for the gay, lesbian, bisexual and transgender community, Cuomo issued new state rules to have taxpayers pick up the tab for low-income New Yorkers, CBS2’s Marcia Kramer reported. Under the proposal, gender reassignment surgery will be available for people who are a minimum age of 18 or 21, depending on circumstances, and will require a referral from a doctor.

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“New York has always been a progressive leader and ensuring that all New Yorkers — regardless of gender identity — are treated fairly will continue this legacy,” Cuomo said in a news release. “This new regulation will guarantee transgender New Yorkers access to Medicaid-funded care, which is critical to safeguarding the principle of equal treatment. I am proud that the State is taking this step and continuing to lead the fight on transgender rights.”

Before the funding for surgery will be made available, patients will have to have received hormone therapy, have lived as a member of the other gender for at least a year and have consulted with a mental health professional.

“Medical evidence supports gender reassignment surgery as a safe and effective treatment for gender dysphoria,” acting Health Commissioner Dr. Howard Zucker said in the news release. “This modernization of our Medicaid payment coverage brings New York State in alignment with Medicare policy and improves the quality of life for New Yorkers whose gender identity is not the gender with which they were born.”

There will be a 45-day public comment period on the proposed legislation.

“I think this is a critical step that the governor took,” said Councilman Corey Johnson, D-Manhattan, a longtime activist for the lesbian, gay, bisexual and transgender community.

“This is not cosmetic in any way,” he added. “This is about their identity and getting health care that is meaningful and real for them.”

Doctors say the needs of the transgender community are both physical and psychological.

“There’s absolutely a medical need to correct it because these patients experiment tremendous upheaval,” said Dr. Daniel Yadegar, a Manhattan cardiologist.

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State officials estimate it will cost $6.7 million to pay for the medical services needed by transgender New Yorkers.

Not everyone agrees with the expenditure.

“Medicaid is designed for the needy, for the dispossessed, for the destitute,” said Bill Donohue of the Catholic League. “It’s not meant for middle-class people and upper-middle-class people who don’t like the fact that they’re a man or woman. … This is an abuse of Medicaid.”

“They should be paying for it out of their own pocket,” said George Brown, of Midtown. “It’s not a responsibility for the state of New York.”

Other New Yorkers, however, supported the move.

“I think it’s probably a good idea because why would you put yourself through that unless you really had to?” said Sue Kort, of Midtown. ”

California, Massachusetts, Oregon, Vermont and Washington D.C. also cover transgender health care through their Medicaid programs.

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