A 30-year-old transgender male schoolteacher going simply by “John Doe” is suing Pennsylvania’s Medicaid system, reports The Advocate. He claims that under new federal nondiscrimination rules, the program is obligated to give him a hysterectomy.
Pennsylvania is one of several states that excludes coverage for transition-related transgender care, but proposed new federal rules for the Affordable Care Act (ACA), which have not yet been implemented, would ban such exclusions. New York and Oregon ended such exclusions in 2014.
According to lawyer Julie Chovanes, a transgender woman who represents Doe and run the Trans Resource Foundation, Obamacare says that the state must provide the coverage. “It can’t be discriminatorily not provided when medically necessary and prescribed by a doctor,” she said. (The man’s doctors have deemed the procedure medically necessary.)
The man’s case has a precedent. Last March, a Minnesota trans man won a key victory when a federal court ruled that health providers and hospitals who take federal Medicare or Medicaid funds are subject to the ACA’s ban on discrimination based on sex, which extends to transgender people.
The Advocate picked up the story from the conservative Washington Times, which denied the plaintiff’s gender identity in its first sentence: “A woman from Pennsylvania who now identifies as a transgender man wants to have his uterus surgically removed…”
According to The Advocate: “If the Pennsylvania lawsuit is successful, it could help prompt a change in the ACA’s interpretation that may allow for greater coverage of gender-affirming surgery… Such an inclusive interpretation would also allow transgender patients to access to broader mental health and transition-related health care…”