The State of Alaska has settled with a trio of people with gender dysphoria who are Medicaid clients and who demanded the government pay for their appearance-transforming treatments, such as hormone therapy and removal of genitals, to help them feel and appear more like the opposite gender.
The settlement is seen as a victory for the Lambda Legal and the Northern Justice Project, which reached a settlement in the class action lawsuit that began in March of 2019.
“Transition-related health care is essential health care, full stop,” said Lambda Legal Staff Attorney Carl Charles in a statement. “Our clients are delighted that the State of Alaska, at long last, recognized that fact. Our clients and other transgender Alaskans will no longer endure the physical, mental, and stigmatizing harm caused by exclusions in the state Medicaid program. This is a significant step toward ensuring the health and safety of all transgender Alaskans, at a time when access to health care is more important than ever.”
The State of Alaska agreed to strike the categorical denial of Medicaid coverage for “treatment, therapy, surgery, or other procedures related to gender reassignment,” and for “transsexual surgical procedures or secondary consequences,” from the state Medicaid plan, which is paid for by taxpayers in Alaska and across the country. Lambda Legal and the Northern Justice Project said the exclusion of these elective procedures violated the Equal Protection Clause of the Fourteenth Amendment to the U.S. Constitution and Section 1557 of the Affordable Care Act.
New regulations have been published by the State of Alaska as part of the settlement of the case known as Being et al. v. Crum et al. The case was named after a person in Homer named Swan Being, who also was awarded $60,000 in damages. The expected increase to the Medicaid budget in Alaska is estimated to be $28 thousand (updated number) a year.
Settlement documents are at this link:
Gender dysphoria is a little understood mental disorder that has no specific cure. Treatments being used right now include hormone therapy that may be feminizing hormone or masculinizing hormone therapy. Increasingly, surgery, that creates or removes breasts or chest fat, creates or removes external and internal genitalia, or alters facial features, and body contours, similar to plastic surgery.
According to one study, about 1 percent of people who underwent these gender reassignment surgeries ended up regretting their decisions, with about one-half percent having major regrets. The study is here. According to the scientists, that is an acceptable level of regret.