TALLAHASSEE, Fla. — Florida’s Medicaid regulator has determined that taxpayer-subsidized health coverage should not include transition-related medical care for the treatment of gender dysphoria, or the feeling of discomfort or distress some transgender people experience when their bodies don’t align with their gender.
What happened: Tom Wallace, the deputy secretary for Medicaid at the Florida Agency for Health Care Administration, submitted a report on Thursday that claims there was no evidence showing that gender-affirming care is a safe and effective way to treat gender dysphoria.
“Rather, the available evidence demonstrates that these treatments cause irreversible physical changes and side effects that can affect long-term health,” the AHCA report states.
Medical associations, including the American Academy of Pediatrics and the American Medical Association, support gender-affirming care for adults and adolescents. But medical experts said gender-affirming care for children rarely, if ever, includes surgery. Instead, doctors are more likely to recommend counseling, social transitioning and hormone replacement therapy.
Wallace assembled the report at the request of AHCA Secretary Simone Marstiller, who asked for a recommendation on whether transition-related medical care should be covered by the state’s $36.2 billion Medicaid program. The 40-plus page report follows a memo written by state Surgeon General Joseph A. Ladapo in April, which warned against treating children with gender-affirming care. Like Wallace, Ladapo also determined there was not enough evidence to declare the procedures as safe for children.
Breaking it down: The AHCA report includes a review of literature that claims the definition of gender dysphoria over the past decade has been inconsistent and there was not enough evidence for Wallace to determine that gender-affirming care reaches the state’s threshold for Generally Accepted Professional Medical Standards. A treatment method has to meet those standards, which is also known as GAPMS, in order for Medicaid to foot the bill, the report states.
The American Medical Association, however, has stated that such care has been shown to be “medically necessary.”
“Gender-affirming care is medically-necessary, evidence-based care that improves the physical and mental health of transgender and gender-diverse people,” said AMA board member Michael Suk in a 2021 statement reiterating its opposition to restrictions on transgender medical care.
Background: Florida was one of at least 17 states in the country that had not taken a position in addressing Medicaid coverage for the treatment of gender dysphoria. If Wallace’s recommendations are applied, Florida will join eight states that also oppose the coverage.
The remaining 26 states include gender-reassignment treatment as part of Medicaid coverage, according to the AHCA report.