Two transgender patients are suing Wisconsin’s health services department for refusing to pay for procedures related to gender transition.
Doctors for Cody Flack and Sara Ann Makenzie say they need surgery to treat gender dysphoria, a condition in which people identify with a gender that is different than the one they were given at birth. Flack and Makenzie have Medicaid, a program paid for by the state and federal government, but the program will not pay for their surgeries because they are deemed by the state to be “medically unnecessary.” Without the coverage, Flack and Makenzie cannot afford the procedures.
“I am bringing this lawsuit to get the medical care I need to finally feel like myself, on the inside and the outside,” Flack told the Associated Press.
The lawsuit, filed in federal court Monday in Madison against the Department of Health Services, argues that there isn’t a rational or legitimate basis for transgender care to be excluded from coverage under Medicaid, a program that covers low-income people. The suit says that excluding transgender care violates Obamacare, the Medicaid Act and the due process guarantee of the 14th Amendment. It asks that the court make the state cover the procedures and award damages to the plaintiffs.
The lawsuit says Flack has “profound depression and emotional distress” and has had suicidal thoughts because he hasn’t been able to fully transition to the gender with which he identifies and Mackenzie has been suicidal and “engaged in self-harming behaviors, including cutting in her genital area.”
When denying the procedures, state officials cited a 1997 regulation in the Department of Health Services that groups the procedure with tattoo removal and earlobe repair, which are determined by officials to be “medically unnecessary.” That includes breast removal or implants, genital surgery or hormone treatment.
Flack and Makenzie are being represented by the National Health Law Program, Relman, Dane & Colfax, a civil rights law firm in Washington, D.C., and Rock Pledl, of McNally Peterson in Milwaukee.
“The Wisconsin policy is nonsensical, not supported by the medical community, and continues to exacerbate gender dysphoria that Mr. Flack and Ms. Makenzie experience,” said Abigail Coursolle, a senior attorney for the National Health Law Program.
Leading medical groups, including the American Medical Association, support the position that gender transition, which can involve hormone therapy and gender-reassignment surgery, is medically necessary for patients with gender dysphoria.
Wisconsin is one of 10 states that denies Medicaid coverage for transgender care. The District of Columbia and 18 states cover transgender care, and others don’t have any policy.
