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Transgender patients are suing because Wisconsin Medicaid doesn't cover gender reassignment surgery

Two transgender patients are suing the Wisconsin Health Department because Medicaid does not cover their gender reassignment surgery. (Getty Images)

Gender reassignment surgery for transgender patients is not covered under Wisconsin's Medicaid program, so two residents are suing the state health department. According to The Hill, the plaintiffs  claim the exclusion is unconstitutional.

The lawsuit alleges that the exclusion of the surgery for transgender patients "flies in the face of the medical consensus that gender-confirming medical care is the only safe and effective medical treatment for gender dysphoria, and wholly disregards the harms of denying transgender people access to critical and often life-saving care."

What's the story?

The plaintiffs in the lawsuit are Cody Flack and Sara Makenzie. Flack is a 30-year-old transgender man, and Makenzie is a 41-year-old transgender woman.

Both of them rely on federal benefits for their basic needs, including health care. They both have been diagnosed with gender dysphoria, meaning they have been diagnosed as having a gender identity that conflicts with their biological sex.

They have already gone through some gender transitions such as hormone therapy, and want to get gender reassignment surgery, having received recommendations from their doctors to do so in order to "alleviate their ongoing symptoms of gender dysphoria."

Neither of them can afford the out-of-pocket cost for gender reassignment surgery, but a state regulation "expressly prohibits Wisconsin Medicaid coverage for 'transsexual surgery' or 'drugs, including hormone therapy, associated with transsexual surgery or medically unnecessary alterations of sexual anatomy or characteristics."

The lawsuit claims that the exclusion violates the Patient Protection and Affordable Care Act, comparability and availability requirements of Medicaid, and the Equal Protection Clause of the 14th Amendment.

What do they want?

Makenzie and Flack want the court to rule that the exclusion of gender reassignment surgery from coverage is discriminatory and unconstitutional; they want an injunction preventing the state from enforcing the exclusion, and they are seeking compensatory damages for "economic and non-economic injuries arising from being denied medically necessary health care coverage."


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