Second victory for transgender rights as court strikes down Medicaid ban on gender care

A federal judge has struck down a Florida law and rule that bans Medicaid payments for gender affirming care.

U.S. District Judge Robert Hinkle declared on Wednesday that Florida's rule and statute that prohibit Medicaid payment for transition care for transgender people violates the federal Medicaid statute, the Equal Protection Clause, and the Affordable Care Act’s prohibition of sex discrimination.

The state of Florida adopted the Medicaid rule in August 2022, and was quickly challenged in court in September by a group of four transgender individuals. The law went into effect in on May 17. Two adults, August Dekker and Brit Rothstein and two transgender minors under the names Susan Doe and K.F. The minors are suing through their parents, identified as John and Jane Doe.

Simone Chriss, Director of the Transgender Rights Initiative for the Southern Legal Counsel, chastised the state policies as politically motivated. Chriss was one of several attorneys who represented the plaintiffs on the case.

"The order is a resounding message to the state that they can't continue to use trans folks as political pawns," Chriss told the USA TODAY NETWORK - Florida on Thursday. "We are incredibly grateful that the court struck down the Medicaid ban, and also recognized the states' justification for these cruel bans."

The USA TODAY NETWORK - Florida has reached out to the DeSantis administration for comment and to ask if they intend to appeal.

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Hinkle declared the Florida law invalid, stating that transgender individuals are entitled to Medicaid benefits and payments, as a matter of medical necessity, for puberty blockers or cross-sex hormones as determined by multidisciplinary teams of medical providers.

"The elephant in the room that should be noted at the outset. Gender identity is real. The record makes this clear," Hinkle wrote in Wednesday's 54-page order.

The ruling means the state must approve Medicaid payment for services rendered for the evaluation, diagnosis, and treatment of gender dysphoria, including surgery, Chriss said.

"The state wants to push this narrative that we are butchers and we are mutilating children, and that's just to get an angry, ignorant, base riled up about something they don't understand," Chriss said. "The reality is children are not receiving surgery. In the very, very, rare instance that anyone under the age of 18 is ever prescribed surgery it is trans males who are seeking top surgery."

The court victory is the second this month for transgender rights activists. On June 6, Hinkle issued a preliminary injunction in a separate but related case filed by seven parents of transgender children. Three of those plaintiffs moved for a temporary injunction because medical professionals indicated their children needed treatment without delay, or would need it soon.

Hinkle granted the preliminary injunction in a narrow ruling, also reiterating that "gender identity is real," and ordering that the state not take steps to prevent the three children from receiving treatment.

"The treatment will affect the patients themselves, nobody else, and will cause the defendants no harm," Hinkle wrote in that order. "The preliminary injunction will be consistent with, not adverse to, the public interest. Adherence to the Constitution is always in the public interest."

Chriss, who is the only attorney representing clients on both cases, said the case challenges the board of medicine rules that went into effect in March banning minors from receiving gender affirming care, and it also challenges provisions passed in SB254 that criminalize doctors and make it a felony for them to provide gender affirming care.

Equality Florida, an LGBTQ advocacy group, issued a statement Thursday morning in support of Hinkle's ruling.

"This ruling affirms what we have long known: the DeSantis Administration's Medicaid rule was politically motivated, denying access to care is against the overwhelming weight of medical authority, and there is no rational basis for a state to ban such care or exclude it from Medicaid coverage," the group said in a news release. 

"This was about discriminatory government overreach into real people's lives."

Jesse Mendoza is a reporter with the Sarasota Herald-Tribune, which is a part of the USA TODAY Network. He can be reached at jjmendoza@gannett.com, or on Twitter at @Reportographer

This article originally appeared on Sarasota Herald-Tribune: Judge nullifies Florida ban on Medicaid payments for transgender care