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The Problem With Pride

Trans Rights Advocates File Lawsuit Challenging Florida’s Ban on Medicaid Coverage for ‘Gender-Affirming’ Care

AP Photo/Armando Franca

A coalition of transgender rights organizations filed a lawsuit over new rule in Florida that prohibits the state’s Medicaid program from covering “gender-affirming” care, which includes hormone therapy treatment, puberty blockers and sex reassignment surgery. 


The lawsuit was filed Wednesday in federal court in Tallahassee, according to Politico. In the complaint, the organizations argue that the rule violates the federal equal protection clause and prevents an around 9,000 transgender Medicaid enrollees in Florida from receiving “gender-affirming” care.

“A person’s access to health care should not be contingent on their sex, gender identity, or whether they are transgender,” the lawsuit reads. “Empirical evidence and decades of clinical experience demonstrate that medical care for the treatment of gender dysphoria, also known as gender-affirming care, is medically necessary, safe, and effective for both transgender adolescents and adults with gender dysphoria. Gender-affirming care is neither experimental nor investigational; it is the prevailing standard of care, accepted and supported by every major medical organization in the United States.”

Politico noted in a separate report this month that Florida saw its amount of Medicaid recipients seeking “gender-affirming” care almost double in recent years.

In July, an ex-trans teenager named Chloe Cole spoke out in a hearing in support of the rule prohibiting Florida Medicaid funds for covering “gender-affirming” care. At age 12, Cole decided she was transgender and medically transitioned during ages 13 to 17, taking puberty blockers and testosterone. She underwent a double mastectomy at 15.

“I really didn’t understand all of the ramifications of any of the medical decisions that I was making,” Cole said during the hearing. “I was unknowingly physically cutting off my true self from my body, irreversibly and painfully.”


Florida Surgeon General Joseph Ladapo posted a video of Cole sharing her story on Twitter. 

“I don’t know if I’ll be able to fully carry a child and I might be at increased risk for certain cancers, namely, cervical cancer,” Cole said. “I’m not able to breastfeed whatever future children I have.”

“That realization actually was one of the biggest things that led to me realizing that this was not the path I should have taken,” she added. 

Last month, Townhall covered how a federal judge ruled that West Virginia Medicaid can no longer exclude coverage for “gender-affirming surgeries.”

U.S. District Judge Robert C. Chambers ruled in favor of a lawsuit filed nearly two years ago by LGBT rights organization Lambda Legal on behalf of two transgender men in West Virginia who were denied “gender-affirming” care under the state’s Medicaid program and the state’s employee health plan.

In his 30-page opinion, Chambers said that the exclusion of this type of care in the state’s Medicaid program discriminates against transgender people on the basis of sex.

It is undisputed that the criteria determining whether or not such treatment is covered under the Medicaid Program hinges on a diagnosis – but when treatment is precluded for a diagnosis based on one’s gender identity, such exclusion invidiously discriminates on the basis of sex and transgender status.


In addition, Chambers claimed that denying a transgender Medicaid recipient of an operation, such as a mastectomy, violates the Medicaid Act. 

Plaintiffs assert that Defendants violate the comparability requirement of the Medicaid Act by providing particular services to some Medicaid participants but not others based solely on diagnosis. The Court has found that the surgeries, such as mastectomies, which are covered to treat non-gender dysphoria diagnoses are materially the same as the surgeries provided to treat gender dysphoria. Thus, the difference in treatment clearly violates the comparability requirement which requires that all persons within a specific category be treated equally.

“The exclusion is aimed specifically at a gender change procedure,” the judge added. “The exclusion targets transgender people because they are transgender.”

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