Florida Rule Banning Medicaid for Transgender Treatments Blocked by US Judge

A transgender flag sits on the grass outside of the U.S. Capitol building in Washington, on May 22, 2023. Anna Moneymaker/Getty Images

Florida’s ban on Medicaid coverage for transgender treatments was struck down by a federal judge, even as the state’s regulator for the health insurance program warned that such procedures can result in harm.

In August 2022, the Florida Agency for Health Care Administration (AHCA) adopted a rule that prohibited state residents from using Medicaid to cover the cost of hormone replacement therapy, puberty blockers, or any other form of procedure aimed at altering the “primary or secondary sexual characteristics” of an individual for the purpose of treating gender dysphoria.

A lawsuit against the rule was filed in September 2022 in the Northern District of Florida. In a 54-page decision on June 21, U.S. District Judge Robert Hinkle, appointed to the court by President Bill Clinton, struck down the new rule adopted by AHCA.

ACHA had earlier claimed that treatments for gender dysphoria may result in potentially harmful effects over the long term.

“There is no rational basis for a state to categorically ban these treatments or to exclude them from the state’s Medicaid coverage,” Hinkle said in his ruling (pdf). He added that Florida’s denial of Medicaid coverage for hormone therapy “also violates the Equal Protection Clause” of the 14th Amendment.

The judge insisted that Florida’s action was “purposeful discrimination against transgenders” and that it wasn’t related to “legitimate state interest.”

Hinkle deemed the ban on Medicaid payment for puberty blockers and cross-sex hormones for gender dysphoria as “invalid.”

The plaintiffs in the case are two transgender adults—August Dekker and Brit Rothstein—as well as two transgender minors who filed under pseudonyms. The defendants were the AHCA and the organization’s secretary, Jason Weida.

AHCA’s Warning

Before banning the use of Medicaid for transgender treatments, the AHCA had issued a 46-page report in June that reviewed medical evidence related to “gender-affirming care” for individuals experiencing gender dysphoria.

It concluded that many of the treatments for the condition, such as puberty blockers and cross-sex hormones, “are not consistent” with generally accepted professional medical standards and that they are “experimental and investigational with the potential for harmful long-term effects.”

There is “insufficient evidence that sex reassignment through medical interventions is a safe and effective treatment for gender dysphoria,” the report said.

Instead, the available evidence points to such interventions causing “irreversible physical changes and side effects that can affect long-term health.”

Earlier this month, Hinkle also temporarily blocked a part of a Florida law that banned transgender procedures for minors, insisting that the rule is likely unconstitutional.

Negative Effect of Treatments

In a recent interview with NTD, James Esses, a commentator and co-founder of Thoughtful Therapists, warned about the dangers of transgender treatments on children, pointing out that such procedures negatively impact brain development and bone growth.

“Cross-sex hormones can have irreversible physical impacts,” he said. “One of the most concerning things is, if a child starts puberty blockers before commencing puberty, and then goes on to take cross-sex hormones straight after that, they can be left permanently infertile.”

Esses expressed concerns about gender ideology invading classrooms.

“I often have parents contact me who are absolutely terrified because of what their children are being taught at school, where they’re not able to monitor it. And often they have a real difficult time even getting hold of the materials that children are being taught at schools.”

Some children have also died while participating in transgender medical studies. On May 9, 15 Republican lawmakers wrote a letter to Dr. Lawrence Tabak, acting director at the National Institutes of Health, after it came to light that two young people committed suicide while taking part in a transgender hormone study funded by the organization.

In addition, 11 participants reported having suicidal thoughts during the study.

The lawmakers wrote, “Rather than shutting the study down after such serious adverse events, the researchers published their paper, concluding that the study was a success because cross-sex hormones had altered subjects’ physical appearance and improved psychosocial functioning.”