Health organizations challenge Florida’s Medicaid rule on transgender treatment

Despite state objections, 22 health care organizations are seeking to bolster a legal challenge to a new Florida rule that prevents Medicaid from paying for treatments such as puberty blockers and hormone therapy for transgender people.

The organizations, including the American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians and the Florida Chapter of the American Academy of Pediatrics, sought a judge’s approval on Tuesday to file a brief in a lawsuit seeking to block the Medicaid Rule.

A copy of the brief, attached to the application, said the rule would “irreparably harm” many Medicaid recipients with gender dysphoria.

“Gender dysphoria is a clinical condition marked by distress due to an incongruity between the patient’s gender identity (i.e. the innate sense of self as a particular gender) and the sex assigned to the patient. birth,” the memoir reads. “This incongruity can lead to clinically significant distress and impair functioning in many aspects of the patient’s life. If left untreated or improperly treated, gender dysphoria can lead to debilitating anxiety, depression, and self-harm, and is associated with higher suicide rates. As such, the effective treatment of gender dysphoria saves lives.

State prosecutors, however, argued against the organizations brief, pointing in part to a hearing U.S. District Judge Robert Hinkle scheduled for Oct. 12 on a plaintiffs’ motion for a preliminary injunction against the rule. State prosecutors wrote that responding to the brief “would divert time and attention from this motion.”

Further, they argued that “the attorneys for the parties are more than capable of presenting scientific arguments and information to this tribunal. Outside help is not necessary.

The rule, proposed this summer by the Florida Agency for Health Care Administration, went into effect Aug. 21 and prohibits Medicaid from reimbursing medical providers for treatments such as puberty blockers, hormone therapy and change surgery. of sex. The agency largely administers the state Medicaid program.

Four transgender plaintiffs filed a lawsuit Sept. 7 challenging the rule, alleging that treatment for gender dysphoria is “medically necessary, safe and effective” for transgender children and adults.

The rule came as Gov. Ron DeSantis and other Republicans in Florida and nationally grappled with transgender issues. Florida Surgeon General Joseph Ladapo, for example, has backed a proposal that could block doctors from providing treatment to transgender people under the age of 18. State medical boards are considering this proposal.

The DeSantis administration defended the new Medicaid rule, relying in part on a report justifying the end of reimbursements for transgender care.

The Agency for Health Care Administration “exercised due diligence” through the report and the rulemaking process, agency spokesman Brock Juarez said in an email afterward. the filing of the complaint.

But state and national medical organizations dispute the report, which they say in the brief “misrepresents professionally accepted medical guidelines for the treatment of gender dysphoria and the evidence supporting the guidelines.” Although the rule applies to minors and adults in the Medicaid program, the brief focused on minors.

“The widely accepted view of the professional medical community is that gender-affirming care is the appropriate treatment for gender dysphoria and that, for some adolescents, gender-affirming medical interventions are necessary,” says the memory. “This care significantly reduces the negative physical and mental health consequences that occur when gender dysphoria is left untreated.”

The brief also detailed the guidelines used in the treatment of gender dysphoria.

“Decisions about the appropriate treatment for each patient with gender dysphoria are made in consultation with the patient, their parents or guardians, and the medical and mental health team,” the brief states. “There is no one-size-fits-all approach to this type of care. »

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