Class Action Lawsuit Challenges Arizona’s Medicaid’s Categorical Exclusion of Surgery for Transgender People
TUCSON—The National Center for Lesbian Rights (NCLR) and the National Health Law Program (NHeLP), along with co-counsel King & Spalding LLP and Perkins Coie LLP, filed a class-action lawsuit challenging Arizona Medicaid’s categorical exclusion for surgical treatment for gender dysphoria.
The named plaintiffs, D.H. and John Doe, are transgender teenagers who require male chest reconstruction surgery to treat their gender dysphoria. Arizona’s refusal to cover this medically necessary treatment violates medical standards of care and is causing D.H. and John to experience serious harms.
The lawsuit alleges that Arizona Medicaid’s categorical exclusion violates the Medicaid Act, the Affordable Care Act, and the Equal Protection Clause of the U.S. Constitution. D.H. and John have also filed a Motion for Preliminary Injunction seeking a court order requiring Arizona Medicaid to cover their surgery immediately to prevent the irreparable harm they will experience by a further delay of this critical care.
“Every day I must wear a very constrictive chest binder to flatten my chest just to function,” said Plaintiff D.H. “But wearing the binder for any extended period of time is painful. The binder is so tight that I cannot breathe fully, making it impossible to be physically active and do the things I love, like dance and theater. That has taken a serious toll on my mental health and I have struggled with severe depression and anxiety as a result of being denied needed care.”
“Categorically excluding surgical treatment for gender dysphoria impermissibly discriminates against transgender people,” said Asaf Orr, Senior Staff Attorney and Director of the Transgender Youth Project at the National Center for Lesbian Rights. “There is no legitimate justification for Arizona’s refusal to provide this critical care to transgender Medicaid recipients. Instead, excluding that care creates unnecessary barriers that prevent transgender young people from thriving in every aspect of their lives and can cause lifelong harms.”
“By accepting federal funds for Medicaid, Arizona agreed to cover medically necessary health care for young people, but it has failed to keep that promise for transgender young people,” said Abbi Coursolle, Senior Attorney at the National Health Law Program. “Male chest reconstruction surgery is essential to the health and wellbeing of transgender young people and federal law requires Arizona to cover it.”
“Coverage determinations must be made by relying on the prevailing standards of care and the experience of health care experts in the field,” said Brent Ray, Partner at King & Spalding LLP. “Arizona’s continued enforcement of its categorical exclusion has no medical basis.”
The National Center for Lesbian Rights (NCLR) is a national legal organization committed to advancing the human and civil rights of the lesbian, gay, bisexual, transgender, and queer community through litigation, public policy advocacy, and public education. Since its founding, NCLR has maintained a longstanding commitment to racial and economic justice and the LGBTQ community’s most vulnerable.
National Health Law Program (NHeLP) protects and advances the health rights of low-income and underserved individuals and families. NHeLP advocates, educates, and litigates at the federal and state levels. Our lawyers and policy analysts stand up for the rights of the millions of people who struggle to access affordable, quality health care. We are guided by the belief – a challenge – that each generation should live better than the last.
[From a News Release]