In a cruel display of transphobia, the Florida Agency for Health Care Administration announced on Thursday that it plans to end coverage of gender-affirming care, including hormone replacement therapy and surgeries, for recipients of Medicaid, including adults.
“The Agency has determined that several services for the treatment of gender dysphoria [...] are not consistent with generally accepted professional medical standards and are experimental and investigational,” AHCA Secretary Simone Marstiller wrote in a release announcing the proposed rule change. Marstiller, a former appeals court judge, was previously Governor Ron DeSantis’s secretary for the Department of Juvenile Justice, until her appointment last year.
Her statements contradict overwhelming and repeatedly confirmed medical consensus regarding the necessity of transition-related medical care. Attemping to counter the long-held view of virtually every major medical association in the country, a new AHCA report accompanying the proposed rule claims that the evidence in favor of gender-affirming care’s safety and necessity is weak or entirely nonexistent. The report specifically challenges the existing literature indicating the beneficial effects of top surgery, and repeats the long-debunked statistic that claimed 80% of trans children eventually identify with their birth-assigned gender
“The Agency will now initiate the rulemaking process regarding the Medicaid program’s coverage treatments for gender dysphoria,” Marstiller summarily noted.
The proposed rule will be published in the Florida Administrative Register and presumably applies to “several services for the treatment of gender dysphoria” that the AHCA falsely claims “are not consistent with generally accepted medical standards,” including gender-affirming surgeries and hormone therapy.
This proposed rule change, which follows an April memo from the state’s Department of Health urging an end to transition-related medical care for minors, could have a massive impact. As of December, there are an estimated 3.7 million people eligible for Medicaid in Florida. According to a report from the Williams Institute at the UCLA School of Law, over 100,000 trans adults live in the state, giving it one of the largest trans populations in the country.
In April, more than 300 medical professionals signed an open letter denouncing the Department of Health’s guidance on youth transition, observing that the state government “cherry-picks and misreads the studies” in direct contradiction to international best practices.
“While we need research to further improve care for transgender and gender diverse youth, taking away social support and medical care is not the answer,” the letter urged.
It’s not surprising that the DeSantis administration has refused to listen. After all, this is the same administration that vetoed mental health funding for survivors of the PULSE mass shooting and passed the infamous “Don’t Say Gay” bill. But it’s another stone on the backs of trans Floridians, whose lives are under increased threat with each passing week.
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