A tentative settlement has been reached in a federal lawsuit challenging the state’s policy of excluding Medicaid coverage for gender-dysphoria treatments.
“John Doe” is a Pennsylvania trans man diagnosed with gender dysphoria who seeks Medicaid coverage for a medically necessary hysterectomy, according to a lawsuit filed in February.
In the past, state officials refused to fund the procedure, citing internal regulations banning Medicaid coverage for gender-dysphoria treatments. But according to Julie Chovanes, an attorney for Doe, state officials recently agreed to lift the ban on Medicaid coverage for gender-dysphoria treatments.
“We’re delighted that Medicaid-eligible trans people with gender dysphoria will be treated like ever other person in the commonwealth,” Chovanes told PGN.
She said both sides continue to finalize terms of the settlement.
“Details of the settlement remain to be worked out,” Chovanes said. “But trans Pennsylvanians can apply for Medicaid coverage for medically necessary gender-dysphoria care immediately.”
She also commended her client for his courage in pursuing the case.
Gender-dysphoria treatments include gender-confirmation therapy, hysterectomies, hormonal therapies, breast reconstruction, penectomies, vaginoplasty, mastectomies, plastic surgery, vaginal dilation and release of labial adhesions.
Chovanes serves as executive director of Trans-Help, a local nonprofit that provides legal and other services to trans people. She said thousands of Medicaid-eligible trans Pennsylvanians will benefit from the new policy.
Any trans Medicaid recipient in Pennsylvania encountering difficulty accessing coverage for gender-dysphoria treatments may contact Chovanes at Julie@trans-help.org.
The named defendant in Doe’s lawsuit is Theodore Dallas, secretary of the state’s Department of Human Services.
In a March legal filing, Dallas asked U.S. District Judge J. Curtis Joyner to dismiss Doe’s suit as meritless. Dallas noted that the state’s Medicaid program doesn’t cover many procedures prescribed by physicians, due to limited funds.
But Doe’s lawsuit contended the gender-dysphoria exclusion violated the equal-protection and supremacy clauses of the Constitution, the federal Medicaid Act and the federal Affordable Care Act.
State officials couldn’t be reached for comment at presstime.
In a prior statement, Gov. Tom Wolf indicated his support for state Medicaid coverage for gender-dysphoria treatments.
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