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Trans advocates criticize Florida rule that bans Medicaid from covering gender-affirming treatment

The progress pride flag. It has the rainbow stripes, and a triangle with the trans pride flag and brown and black stripes.
Daylina Miller
/
WUSF

Under the rule, the Medicaid program would not cover puberty-blocking medication, hormones and hormone “antagonists,” gender affirmation surgeries and any “other procedures that alter primary or secondary sexual characteristics.” It goes into effect Aug. 21.

On Aug. 1, the state Agency for Health Care Administration quietly finalized a rule that bans Medicaid from covering gender-affirming care for many poor and disabled transgender people.

A state report says the Medicaid program “has determined that the research supporting sex reassignment treatment is insufficient to demonstrate efficacy and safety.”

Carl Charles, a senior attorney with Lambda Legal, said the state’s arguments are flawed.

“The state Department of Health went out of its way to produce a 40-page memo that contains a lot of misinformation about the available data. It cites two ‘experts’ who do not actually treat transgender people, but were cherry-picked for their oppositional views to this care."

He accuses AHCA for ignoring “thousands of comments” from people opposed to the rule, and said a public hearing about the rule in July involved “inflammatory talking points” and mistruths about sterilizing surgeries for children.

“Let me be incredibly clear, children are not experiencing any kind of surgery, right? That is not indicated for them,” Charles said. “At most, if medically appropriate, and monitored by doctors and other professionals, some trans children do access puberty-delaying medication.”

And those puberty blockers are reversible. But for most children, transition means a haircut and a change of clothes, new pronouns and potentially a new name.

Seven scientists and a Yale law professor have countered with a report that said the state study’s “conclusions are incorrect and scientifically unfounded.”

Nikole Parker is a transgender woman, and the Director of Transgender Equality for Equality Florida. She said decades of research supports gender-affirming care.

"I transitioned some years ago, and the fact that I was able to access gender-affirming care is the only reason that I'm alive today. And the fact that they are removing it from trans individuals that are on Medicaid is going to be astronomically horrendous. For our community, it is going to cause increased rates of depression, suicide."

She said the decision was entirely political, and not based in science.

“We should leave the politics out of it,” Parker said. “And we should let medical professionals who see trans people every day, who provide this care and know exactly what it does and how it is, in fact, lifesaving, we should let those folks take the lead instead of politicians coming in and wanting to just demonize the trans community to garner votes.”

Lambda Legal, Southern Legal Counsel, Florida Health Justice Project, and National Health Law Program issued a statement vowing to fight the rule, and while they would not comment on specific, lawsuits could be next.

They encourage any transgender person, who is a Medicaid participant in Florida and is at risk of losing Medicaid coverage for their gender-affirming health care to:

I took my first photography class when I was 11. My stepmom begged a local group to let me into the adults-only class, and armed with a 35 mm disposable camera, I started my journey toward multimedia journalism.
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