Last week, Lambda Legal added two more plaintiffs to its lawsuit, Fain v. Crouch, challenging West Virginia’s new law denying gender-confirming health care for transgender individuals who have government-issued insurance.
The two of the three original plaintiffs are transgender men (the third is one’s spouse) covered by Medicaid and PEIA (Public Employee Insurance Agency) respectively. “Gender-confirming health care,” as specified by the lawsuit, “includes, but is not limited to, counseling, hormone replacement therapy and surgical care.” One was denied coverage for hormones to treat his gender dysphoria. Both were denied mastectomies, and have been fighting for equal access to health care since at least 2019. The two new plaintiffs are transgender women, one of whom is on Medicaid while the other uses PEIA.
Even though Medicaid is a federal program, it is administered by the states. PEIA is also administered through the state of West Virginia, and the West Virginia Department of Health and Human Resources has laid a blanket exclusion on gender-confirming care.
According to the complaint, the DHHR Medicaid Policy Manual states “[t]ranssexual surgery” is excluded from coverage, and the managed care organization used by the primary plaintiff denies coverage for “[s]ex transformation procedures and hormone therapy for sex transformation procedures.” PEIA plans exclude “[s]urgical or pharmaceutical treatments associated with gender dysphoria or any physical, psychiatric, or psychological examinations, testing, treatments or services provided or performed in preparation for, or as a result of, sex transformation surgery.”
That’s a steaming load of bull feces.
The government should not have the ability to deny anyone medically necessary health care.
A state government shouldn’t have the ability to deny a specific class of people medically necessary health care in contradiction to federal law.
A state agency definitely shouldn’t have the power to unilaterally decide what health care will be provided to recipients of government-funded insurance.
And what is considered “medically necessary” should be between a person and their doctor.
Gender-confirming health care doesn’t hurt anyone. But the denial of it can be devastating — and life-threatening.
A study done by the UCLA Williams Institute found: “Those who wanted, and subsequently received, hormone therapy and/or surgical care had substantially lower prevalence of past-year suicide thoughts and attempts than those who wanted hormone therapy and surgical care but had not received them.” Those who were able to get their hormones from professionals also reported fewer suicide thoughts/attempts than transgender individuals who had to rely on other means of getting hormones, including from friends who did have access.
The DHHR and PEIA are blatantly wrong in refusing appropriate care for transgender individuals. Period.
