Taxpayers must pay for sex reassignment surgery, judge rules

(Photo by Drew Angerer/Getty Images)

A federal judge appointed by former President Barack Obama has ruled that Wisconsin taxpayers should essentially cover the cost of transgender sex reassignment surgery for Medicaid recipients.

U.S. District Judge William M. Conley issued a permanent ruling that Medicaid cannot exclude medical treatments for any of the low-income residents in Wisconsin who are suffering from “gender dysphoria.”

Residents of the state will now be footing the bill as the publicly funded insurance will look to cover the costly sex surgeries and hormonal procedures, with treatments including “gender confirmation surgery, elective mastectomies, hysterectomies, genital reconstruction and breast augmentation,” according to Judicial Watch.

Conley issued a preliminary injunction last year after two transgender individuals who were living in Wisconsin filed a lawsuit alleging that Medicaid had provided them with inferior healthcare due to their sex. Cody Flack of Green Bay and Sara Makenzie of Baraboo reportedly suffer from “severe gender dysphoria that requires costly surgery,” according to the watchdog group.

Citing guidelines that have been issued by the World Professional Association of Transgender Health, the Obama-appointed judge issued the ruling last week. The surgeries are expected to cost up to $1.2 million annually, officials estimated.

According to Judicial Watch:

Flack, a woman, claims to be ashamed of her breasts and wants to have them surgically removed as she transitions into a man’s body. To make a case for the government to pay for her surgery, she claims that she engages in “binding,” which flattens her breasts and causes sores, skin irritation and respiratory distress. Flack also has difficulty binding her breasts due to a disability, according to court documents. Makenzie, a man who legally changed his name to Sara and wears women’s clothing, says his “male-appearing genitalia” causes him “great distress” and negatively affects his sexuality and social life. Showering and seeing his body in a mirror is “painful,” court records state, and Makenzie fears someone will be able to see his “male genitals” through his clothing.

“As a group, transgender individuals have been subjected to harassment and discrimination in virtually every aspect of their lives, including in housing, employment, education, and health care,” Conley wrote in the injunction last week which directed Medicaid to pay for all gender confirmation operations in Wisconsin.

“Their own families, acquaintances and larger communities can be sources of harassment. For some transgender individuals, though certainly not all, the dissonance between their gender identity and their naturally assigned sex can manifest itself in the form of gender dysphoria, a serious medical condition recognized by both sides’ experts and the larger medical community as a whole,” the court document continued.

Flack’s chest reconstructive surgery was ultimately completed after Conley issued the injunction following the Medicaid denial.

“Following the surgery, Cody’s gender dysphoria was greatly diminished,” the judge’s final ruling stated, because his “outward appearance matched his male gender” and he “would no longer be misgendered because of his breasts.”

Treatments for transsexual, transgender and gender nonconforming people that will now be covered include psychotherapy, hormone therapy and “a number of surgical procedures.”


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