Two transgender people have sued the state of Florida for violating their rights. The alleged offense? The health insurance the state provides to government employees does not cover gender reassignment surgeries.
Jami Claire, 62, and Kathryn Lane, 38, reportedly think Florida’s state healthcare policy violates both their constitutional rights and Title VII of the Civil Rights Act of 1964. The left-leaning American Civil Liberties Union and Florida and Southern Legal Counsel filed a lawsuit on their behalf arguing Claire and Lane have gender dysphoria, that the condition has worsened since they’ve been unable to medically transition, and that a medical transition would be the proper course of action to resolve their dysphoria.
In their lawsuit, Claire and Lane argue that they have not been treated equally because state health insurance covers similar procedures for “cisgender people,” aka non-transgender people, but does not cover the procedures for them simply because they are transgender.
The lawsuit reads: “As a result of the State Plan Exclusion … [the state] single[s] out transgender employees, like Plaintiffs, for unequal treatment by categorically depriving them of coverage for genderaffirming care through the State Plan Exclusion. Other State employees who are not transgender do not face categorical exclusions barring coverage for medically necessary health care.”
NBC News put it another way: “For example, if a cisgender Florida state employee required an orchiectomy as treatment for testicular cancer, it would be covered by his state-provided plan. However, if a transgender woman sought the same surgery to eliminate testosterone production and alleviate gender dysphoria, it would not.”
To call this discrimination is wildly exaggerated foolishness. An orchiectomy is a surgical treatment where one or two testicles are removed that would hopefully cure testicular cancer, hence fully justifying it being covered. Unlike that procedure, it is disputed whether or not a medical transition (surgical, hormonal, and chemical) is actually a legitimate treatment that cures gender dysphoria or even abates the symptoms at all. While some groups such as the American Medical Association back medical transitions, other doctors and experts question the treatment’s effectiveness.
Johns Hopkins University School of Medicine Distinguished Professor of Psychiatry Dr. Paul McHugh, an expert in this field, filed a brief with the Supreme Court on this topic recently. He argues that evidence-based medicine does not support affirmation, and “those who are affirmed in their gender beliefs progress from social transition to surgical interventions at their peril. Indeed, if the evidence shows us anything, it indicates that those who progress all the way through surgery fare poorly.”
He also said, “subjecting gender dysphoric persons to [the three phases of transition: social, hormonal therapy, and surgical interventions] is risky because there is little evidence that social transition is the panacea that the AMA [American Medical Association] makes it out to be.”
Some with personal experience with gender dysphoria also contest the effectiveness of medical transition.
For example, James Shupe was the country’s first legally-recognized nonbinary person. He transitioned from male to female to nonbinary until he realized his own gender dysphoria was due to trauma. He now lives as his birth sex, male. Shupe told me that he believes the problem with the lawsuit “is the pretense the surgeries are being used under — the fictitious claim of confirming a gender identity — which is something that hasn’t been proven yet to exist.”
I asked Shupe where this would end, if state employers were forced to cover surgeries like this for transgender people, not to cure a disease like cancer, but a mental disorder such as gender dysphoria. For example, what’s to stop a perfectly healthy woman with gender dysphoria from requiring insurance to pay for two phalloplasties instead of just one?
“It doesn’t end,” Shupe said. “They want from A to Z: From hair removal to fake breasts to fake vaginas. [I]t’s less about adults having autonomy over their bodies and all about the insurance companies being duped into paying for this stuff under the pretense of it being medically necessary and then used to advance the lie that they’re not really their birth sex.”
As harsh as it may sound, Shupe is on to something.
One of the transgender people in the lawsuit, Claire, had started to transition socially but had to stop during divorce due to funds. Claire then began pursuing the concept of payment via insurance company for a medical transition and, according to NBC News, had been “forced to pay out of pocket for all of transition-related expenses.” This is how it should be.
State insurance companies must hold the line on covering transgender surgeries, not out of bigotry — every transgender person should be treated with respect and receive the best medical care possible — but out of concern for their health and a desire to uphold the Hippocratic Oath, “First, do no harm.”
Until the dispute is settled and medical transitions are proven to be a cure for dysphoria, they should be viewed as optional and, therefore, up to the transgender person who wants the surgeries to pay for them on their own.
Nicole Russell (@russell_nm) is a contributor to the Washington Examiner’s Beltway Confidential blog. She is a journalist who previously worked in Republican politics in Minnesota.
