Judge rules West Virginia’s Medicaid exclusion of transgender surgery unconstitutional

Following a federal judge’s decision, low-income transgender citizens of West Virginia will soon be able to receive gender-conforming surgical care.

HUNTINGTON, WV (CN) — Following a federal judge’s ruling, low-income transgender citizens of West Virginia will soon be able to receive gender-conforming surgical care.

Two years ago, Christopher Fain filed a class action lawsuit on behalf of more than 600 transgender residents against the state Department of Health and Human Resources, challenging the Bureau’s blanket exclusion from surgical care coverage. of the Department’s medical services in its Medicaid program. and government employee health insurance plans. Specifically, the complaint asserted that the exclusion of “transgender surgery” regardless of medical necessity violated the plaintiffs’ rights to equal protection under s.e Amendment.

On Tuesday, U.S. District Judge Robert C. “Chuck” Chambers agreed. Not only did Chambers rule WVDHHR’s exclusion unconstitutional, but also granted the lawsuit class action status.

In a 30-page opinion, Chambers said the WVDHHR facially discriminates against transgender residents by excluding them from medically necessary surgeries granted to other Medicaid recipients.

“The relevant comparison here is people seeking the same medically necessary surgeries for treatments unrelated to gender dysphoria,” Chambers said.

“The West Virginia Medicaid program provides, for example, medically necessary mastectomies for diagnoses unrelated to gender dysphoria. The only difference between this scenario and the applicants’ circumstances is that the applicants are seeking these surgeries to treat gender dysphoria – therefore, a distinction based on their transgender identity.

Additionally, Chambers said following the 2020 U.S. Supreme Court ruling in Bostock v. County of Clayton, Georgiathe fact that the WVDHHR limits transgender people from receiving surgical care for gender dysphoria is in itself gender discrimination.

“As to the language of the exclusion, Chambers said, “it is clear that the exclusion is discriminatory on its face. The exclusion denies coverage for “transsexual surgery”. This language makes explicit reference to sex – anyone seeking “transgender surgery” seeks to transition from their sex assigned at birth to sex that more accurately reflects their gender identity.”

“Only people who identify as transgender would seek ‘transsexual surgery,'” he added, “and as the Supreme Court reasoned in Bostock v. Clayton County, Georgiaone cannot consider the term “transgender” without considering gender. »

“This is a victory not just for me, but for other transgender Medicaid participants across West Virginia,” Fain, 46, said in a press release issued by the Lambda Legal Defense and Education Fund, a New York, New York LGBT civil rights organization that supported the class action lawsuit.

“This decision validates, confirming that after years of struggling to prove gender-confirming care is medically necessary, we should have access to the same services that West Virginia Medicaid already provides to cisgender participants,” he added. . “West Virginia transgender people should never feel like our lives are worth less than others,”

Anna P. Prakash of the Minneapolis law firm Nichols Kaster is lead counsel in the lawsuit. Walk Auvil with the Labor Law Center in Parkersburg is a local attorney.

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