Federal judge orders Wisconsin to pay for gender reassignment surgeries

Sep 2012
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Three for the "WIN" column...

Federal judge orders Wisconsin to pay for gender reassignment surgeries
A federal judge on Wednesday ordered Wisconsin to cover the costs for gender reassignment surgeries for two transgender Medicaid recipients.

Wisconsin residents Cody Flack and Sara Ann Makenzie filed a lawsuit in April over a state rule adopted in 1996 that denied coverage for undefined "transsexual" surgeries, according to The Associated Press.

In the suit, Flack and Makenzie argued that the state rule denying them coverage for surgeries to treat their gender dysphoria is a violation of the Affordable Care Act and their rights to equal protection. They argued that the treatment they are seeking is medically necessary, according to the Milwaukee Journal Sentinel.

U.S. District Judge William Conley reportedly granted a preliminary injunction barring the state rule's enforcement.

The judge also reportedly suggested that the injunction could be expanded to include covering surgeries treating gender dysphoria for any transgender patient on Medicaid whose doctor recommends the procedure.

[…]

The move arrives on the heels of an Iowa judge's ruling last month that the state cannot deny two transgender women Medicaid coverage for gender reassignment surgery.

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Ian Jeffrey

Council Hall
Mar 2013
77,250
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Vulcan, down the street from Darth Vader
Hm...

"Flack and Makenzie argued that the state rule denying them coverage for surgeries to treat their gender dysphoria..."

I am not quite sure I buy this. Gender dysphoria is a state of distress - a mental illness defined (in Wikipedia) as "the distress a person experiences as a result of the sex and gender they were assigned at birth. In this case, the assigned sex and gender do not match the person's gender identity..." Psychiatry.org defines it similarly. There is nothing physically wrong with the person; it is a psychological/psychiatric condition that not all transgendered persons necessarily experience.

While Medicaid should certainly finance psychological and psychiatric services, it is questionable whether sex reassignment surgery is not an elective surgery, but it would seem to be.

On the other hand, since this is a somewhat rare set of procedures anyway, the amount to be spent by the public is probably negligible in the larger scheme ... probably not even a blip on the budget, and it would seem to me we also have bigger problems than worrying about these few cases. We should probably just fund it and move on to real public finance problems.
 
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Jun 2014
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I am not quite sure I buy this. Gender dysphoria is a state of distress - a mental illness defined (in Wikipedia) as "the distress a person experiences as a result of the sex and gender they were assigned at birth. In this case, the assigned sex and gender do not match the person's gender identity..." Psychiatry.org defines it similarly. There is nothing physically wrong with the person; it is a psychological/psychiatric condition that not all transgendered persons necessarily experience.

I think that if a person was truly born intersex, then the treatment should be considered non-elective.
 
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Ian Jeffrey

Council Hall
Mar 2013
77,250
46,613
Vulcan, down the street from Darth Vader
I think that if a person was truly born intersex, then the treatment should be considered non-elective.
Almost certainly. But that is not remotely the same thing.

Or is it? It is entirely possible that the transgender phenomenon is the result of some form of chimerism (perhaps tetragametic) such that the issue is one's brain chemistry, not merely psychological self-perception or some form of psychiatric disorder.
 
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Nov 2015
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If you wanted a healthy limb, nose or ear cut off, you would be classed as mentally ill. But if you want your boobs or willy cut off......
 
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