Federal judge rules West Virginia Medicaid must provide coverage for gender-related surgeries

On Tuesday, District Judge Robert C. Chambers ruled that West Virginia Medicaid must provide coverage for the surgical treatment of gender dysphoria. The district judge declared that Medicaid's exclusion for gender surgery "invidiously discriminates on the basis of sex and transgender status."

Prior to the ruling, West Virginia Medicaid would not cover "transsexual surgery." However, the policy did cover other transgender treatments, including psychiatric diagnosis evaluation, counseling, and hormones. Medicaid's coverage policy on gender surgery varies state by state.

In May, Florida Governor Ron DeSantis received pushback from leftists when he announced that he would support a ban on gender surgeries for minors. DeSantis compared such surgeries on children to allowing 12-year-old to get a tattoo. A month later, Florida put out a press release stating that "gender reassignment surgery should not be a treatment option for children or adolescents."

The Justice Department challenged an Alabama law that attempted to criminalize gender surgery for children. In the April complaint, the DOJ stated that the "new law's felony ban on providing certain medically necessary care to transgender minors violates the Fourteenth Amendment's Equal Protection Clause."

Judge Chambers' ruling argued that denying surgical coverage violates 14th Amendment rights. The amendment grants all people "equal protections of the law."

Judge Chambers also addressed the debate regarding the medical necessity for surgery. The ruling cited Dr. Schechter's expert report, which claimed that the medical community agrees about surgical procedures as a treatment for gender dysphoria. Further, Dr. Schechter stated that the surgery is "not experimental" and is "medically necessary."

The ruling also argued that denying coverage for gender-affirming surgery violates the Affordable Cares Act, the comparability requirement of the Medicaid Act, and the availability requirement of the Medicaid Act.

The lawsuit was filed by Lambda Legal and the Employment Law Center in 2020. Following the ruling, Lambda Legal staff attorney Avatara Smith-Carrington stated, "We applaud Judge Chambers' decision to remove the discriminatory barrier to accessing medically necessary, gender-confirming surgical care for all transgender West Virginia Medicaid participants. Protecting and advancing health care for transgender people is vital, sound, and just. Transgender West Virginia Medicaid participants deserve to have equal access to the same coverage for medically necessary healthcare that cisgender Medicaid participants receive as a matter of course."

Plaintiff Shauntae Anderson expressed excitement following the ruling and said, "Gender-confirming care is healthcare, and it is lifesaving."

Another plaintiff in the case, Christopher Fain, called it a victory for the transgender community and noted, "Transgender West Virginians should never feel as if our lives are worth less than others."

Chambers is a former Democratic member of the West Virginia House of Delegates and was appointed to the bench by former President Bill Clinton.