ACLU wants state government to pay for 'transition surgery' for transgenders

MINNEAPOLIS (Christian Examiner) – The American Civil Liberties Union has filed a lawsuit in Minnesota State Court to force the state to fund transition surgery for transgenders, or people suffering from the psychological disorder "gender dysphoria."

Currently, state law forbids the expenditure of public funds in its Medical Assistance and Minnesota Care programs, both of which are intended to serves as a low-cost insurance safety net for the poor, for gender reassignment surgery. Both programs cover surgical procedures considered "medically necessary."

"But for gender dysphoria, Minnesota law mandates a sweeping and categorical exclusion of all transition-related surgical care without any regard to whether the treatment is medically necessary for an individual recipient," the ACLU said in a statement. "As a result of this sweeping exclusion, most surgical treatments for gender dysphoria are excluded from coverage, even though the same or substantially equivalent treatments are required to be covered under the federal Medicare program and private insurance plans regulated by the state of Minnesota."

Medical Assistance excludes them from coverage, even though decades of research have shown these surgeries to be medically necessary. Nearly all of these surgeries are covered for people with other diagnoses, but they're denied for gender dysphoria. This is harmful to the mental and physical health of many transgender people, and it's also unjust: Transgender people have the same right to health care as everyone else.

Joshua Block, an ACLU attorney in the liberal organization's litigious Lesbian, Gay, Bisexual and Transgender Project, called transition surgery for those suffering from gender dysphoria a "medical necessity" on par with other life-saving surgeries.

"Every major medical organization has recognized that policies banning coverage for medically necessary transition care have no basis in modern medical science. Minnesota's statute is a historical relic based purely on disapproval of transgender people."

The ACLU case was filed on behalf of Evan Thomas, who describes himself as a man needing "relief from the pain of living in a female body," and OutFront Minnesota, the largest gay rights organization in the state. Thomas is covered under the state's Medical Assistance insurance and has been diagnosed with gender dysphoria.

In a blog posting, Thomas – born female – described a life of depression resulting from a lack of acceptance as a man in society. After being diagnosed with gender dysphoria, Thomas began taking the male hormone testosterone, legally adopted a male name, and filed the legal paperwork to be recognized as a man.

"For transgender people who feel this level of dysphoria, the next step is surgery to align the body with the mind. Transition-related surgery can include chest surgery, removal of reproductive organs, genital reconstruction, and other procedures," Thomas wrote.

"Medical Assistance excludes them from coverage, even though decades of research have shown these surgeries to be medically necessary. Nearly all of these surgeries are covered for people with other diagnoses, but they're denied for gender dysphoria. This is harmful to the mental and physical health of many transgender people, and it's also unjust: Transgender people have the same right to health care as everyone else. This is why, with the help of the American Civil Liberties Union and the ACLU of Minnesota, I'm challenging Minnesota's ban on Medical Assistance coverage of this important part of health care for transgender people."

According to the ACLU, 10 states and the District of Columbia provide insurance coverage for transition-related surgeries as part of their insurance programs. In 2014, the Obama administration lifted a 33-year ban on the coverage of gender reassignment surgeries under Medicare, the government's largest insurance program for the elderly.

Last year, Aetna also added gender reassignment surgery to its insurance plans for more than 33,000 government employees. The number of companies with 500 employees or more that offer coverage for the surgery also rose from 5 percent to 8 percent over the past two years.

Minnesota Care also does not cover cosmetic surgery for heterosexuals or those not suffering from gender dysphoria.