Wisconsin Medicaid program must cover sex reassignment surgery, judge rules
A federal judge has struck down a Wisconsin policy that blocked Medicaid funds in the state from being used for coverage of gender reassignment surgeries and cross-sex hormone therapy for trans-identified individuals.
The ruling last Friday comes from U.S. District Judge William Conley in Western Wisconsin who sided with four transgender Medicaid recipients in the Badger state.
The plaintiffs sued the state’s Department of Health and Human Services over a provision enacted in 1997 that barred coverage of “transsexual surgery.”
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According to Madison.com, Conley argued in his 38-page ruling that there is “now a consensus in the medical profession that gender dysphoria is a serious medical condition.”
The plaintiffs argued in their case that gender reassignment procedures and hormone therapy were medically necessary because they were struggling with gender dysphoria, a condition in which a person feels there is a mismatch between their biological sex and gender identity.
Conley contended that if gender dysphoria is not adequately treated, it could “cause adverse symptoms, such as anxiety, depression, serious mental distress, self-harm and suicidal ideation."
Conley, nominated in 2009 by Democrat President Barack Obama, reasoned that the state Medicaid program, which is fueled by state and federal funds, discriminated on the basis of sex under the Affordable Care Act.
In 2016, the Obama administration’s Department of Health and Human Services implemented an Obamacare regulation that required doctors, health care providers and health care providers and insurers to perform, provide or cover gender transition procedures.
The Obama administration interpreted civil rights law that bans discrimination on the basis of sex to also include discrimination on the basis of gender identity and sexual orientation. As a result, faith-based care providers were sued for not providing gender reassignment surgeries.
The Obama-era interpretation has been rejected under the Trump administration.
In his ruling last Friday, Conley pointed out that Wisconsin is among nine states that have Medicaid exclusions for gender-conforming treatments.
The judge further argued that insurance companies that manage the state HMO Medicaid plans “acknowledge that gender-confirming hormone and surgical treatments for gender dysphoria can be medically necessary.”
According to Conley, the state HHS estimates that covered treatments would cost about $300,000 to $1.2 million yearly.
A spokesperson for Wisconsin HHS told The Christian Post that the agency can't offer a comment on how the state will respond to Conley’s ruling.
Conley had previously issued a temporary injunction against the Wisconsin HHS provision last year, blocking the state from implementing the rule. Conley also sided with transgender residents in another legal case against state policy.
Last October, Conley awarded two transgender state employees $780,000 after the state refused to cover sex-reassignment surgeries and hormone therapy in its employee health care plans.
Earlier this year, the Wisconsin Group Insurance Board announced that it would cover gender reassignment procedures and hormone treatments for transgender state employees.
The American Academy of Pediatrics released a guideline last year calling on doctors and insurance providers to provide "comprehensive care" for transgender children and adolescence.
However, a conservative association of doctors called the American College of Pediatricians warned about the dangers of sex reassignment procedures and hormone treatments.
In an online statement from 2017, the organization refuted claims that hormone therapy and gender reassignment procedures help minimize anxiety or depression among trans-identified individuals.
“Rates of suicide are nearly twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery, even in Sweden which is among the most LGBTQ–affirming countries,” the statement of concerns reads.
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