Story at a glance

  • Two Arizona teenagers filed a class action lawsuit against Arizona Medicaid alleging discrimination when the agency refused to cover their chest reconstruction surgeries.
  • Both teenagers received professional recommendations from their primary care physicians.

Two teenagers filed a class action lawsuit against Arizona’s Medicaid agency on Thursday. The plaintiffs, who are transgender, allege that their civil rights are being violated by the state health insurance program’s restrictions on covering gender reassignment or gender affirming surgeries.

NBC News reports that the suit estimates that about 100 Arizonans would be affected by the suit, which reportedly aims to create a class action for Arizona Medicaid recipients under the age of 21 who wish to undergo chest reconstruction surgery for a diagnosis of gender dysphoria.

Class in this case is defined as “individuals who have been unable and will be unable” to qualify for state Medicaid coverage through the Arizona Health Care Cost Containment System "for medically necessary male chest reconstruction surgery because of the [ban], and as a result, have faced or will face delayed or denied access to these medically necessary treatments.”


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The suit details that the two plaintiffs came out as transgender several years ago and faced difficulties since puberty, where the child’s body begins to grow into that of an adult’s. The two plaintiffs adjusted by using uncomfortable chest binders. Eventually, both teens’ health care providers recommended chest reconstruction procedures. 

Since chest reconstruction procedures fall under the category of gender reassignment surgery, the plaintiffs were ruled ineligible for Medicaid funding, per Arizona’s 1982 ban on the state funding the procedure, despite the professional recommendations of two doctors. 

Asaf Orr, an attorney and director at the Transgender Youth Project at the National Center for Lesbian Rights who is working on the suit, said in a statement that Arizona Medicaid violated the Medicaid Act, the Affordable Care Act, and the Equal Protection Clause in the U.S. Constitution by refusing to cover the operation.

“Categorically excluding surgical treatment for gender dysphoria impermissibly discriminates against transgender people,” Orr said. “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.”

Multiple lawsuits have emerged over the years alleging discrimination in states that refuse to cover transgender health care. NBC writes that earlier this week, an Iowa appeals court dismissed a lawsuit challenging a similar law regarding Iowa’s Medicaid policies, and a transgender man sued the University of Maryland Medical System when one of its subsidiaries canceled his gender-affirmation surgery. 

In July, multiple Democratic state attorneys general sued the Trump administration in a bid to block the overturning of an Obama-era rule that protected transgender people in the U.S. health care system. 


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Published on Aug 10, 2020