'Medical necessity': Florida judge strikes down ban on Medicaid-funded gender-affirming care

21 June 2023

The United States District Court for the Northern District of Florida in Tallahassee on Wednesday struck down Republican Governor Ron DeSantis' ban on Medicaid providing gender-affirming care for residents of the Sunshine State.

"The elephant in the room should be noted at the outset. Gender identity is real," Judge Robert L. Hinkle wrote in a fifty-four-page bench trial verdict.

"The record makes this clear. The defendants, speaking through their attorney, have admitted it," Hinkle, a Bill Clinton appointee, continued. "At least one defense expert also has admitted it. That expert is Dr. Stephen B. Levine, the only defense expert who has actually treated a significant number of transgender patients. He addressed the issues conscientiously, on the merits, rather than as a biased advocate."

Hinkle said, "Those whose gender identity does not match their natal sex often suffer gender dysphoria. The widely accepted standard of care calls for evaluation and treatment by a multidisciplinary team. Proper treatment begins with mental-health therapy and is followed in appropriate cases by GnRH agonists and cross-sex hormones."

Hinkle concluded, "Florida has adopted a rule and statute that prohibit Medicaid payment for these treatments even when medically appropriate. The rule and statute violate the federal Medicaid statute, the Equal Protection Clause, and the Affordable Care Act’s prohibition of sex discrimination. These plaintiffs are Medicaid beneficiaries who are entitled to payment, as a matter of medical necessity, for puberty blockers or cross-sex hormones as appropriately determined by their multidisciplinary teams of providers."

This is a breaking news and developing story.

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