U.S. District Judge Robert struck down Florida’s prohibition on Medicaid coverage for gender-affirming care. It is the second decision to erase restrictions authored by State Representative Randy Fine with the backing of Gov. Ron DeSantis.
Hinkle concluded that the ban on Medicaid payments violated two federal health care laws and the Equal Protection clause of the Constitution. This ruling not only applies to the individuals who brought forward the lawsuit like his previous ruling, but to everyone. It is estimated that up to 9,000 Medicaid enrollees in Florida are transgender.
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“Gender identity is real. Those whose gender identity does not match their natal sex often suffer gender dysphoria. The widely accepted standard of care calls for evaluation and treatment by a multidisciplinary team. Proper treatment begins with mental-health therapy and is followed in appropriate cases by GnRH agonists and cross-sex hormones,” Hinkle wrote in his opinion “Florida has adopted a rule and statute that prohibit Medicaid payment for these treatments even when medically appropriate.”
In 2022, the AHCA for the first time, hired outside consultants to conduct a report at the behest of the Governor.
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Hinkle said the report was “from the outset, a biased effort to justify a predetermined outcome, not a fair analysis of the evidence. The report concluded that gender-affirming medical care — puberty blockers, cross-sex hormones, and surgery — were not supported by generally accepted medical standards and were instead experimental. The conclusion was not supported by the evidence and was contrary to generally accepted medical standards.”
He also said that the Agency for Health Care Administration “conducted a well-choreographed public hearing that was an effort not to gather facts but to support the predetermined outcome.”
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Hinkle stated that the DeSantis administration has accused organized medicine of pursuing “good politics” and not “good policy.” Hinkle likened the argument to the “pot calling the kettle black.” And while the DeSantis administration often asserts Florida’s policies on puberty blockers and cross sex hormones mirror those in Europe, which Hinkle said that is not true.
“The assertion is false. And no matter how many times the defendants say it, it will still be false. No country in Europe — or so far as shown by this record, anywhere in the world — entirely bans these treatments or refuses to pay for them,” Hinkle wrote, citing a June 20, 2023, court opinion in another lawsuit.
“To be sure, there are countries that ban gays and lesbians and probably transgender individuals, too. One doubts these treatments are available in Iran or other similarly repressive regimes. But the treatments are available in appropriate circumstances in all the countries cited by the defendants, including Finland, Sweden, Norway, Great Britain, France, Australia, and New Zealand. Some or all of these insist on appropriate preconditions and allow care only in approved facilities — just as the Endocrine Society and WPATH standards insist on appropriate preconditions, and just as care in the United States is ordinarily provided through capable facilities. Had Florida truly joined the international consensus — making these treatments available in appropriate circumstances or in approved facilities — these plaintiffs would qualify, and this lawsuit would not be necessary.”
During debate and hearings on the legislation, its author Representative Fine called the treatments for minors “evil” and “child abuse” and those who conduct the treatments, “child mutilators.”
DeSantis said the new law would “permanently outlaw the mutilation of minors,” and that puberty blockers would bring on “irreversible changes.”
The treatment is actually recommended by AMA and the American Academy of Pediatrics. Medical experts also point out that gender-affirming care for children rarely, if ever, includes surgery. Physicians are much more likely to recommend counseling, social transitioning and hormone replacement therapy.
Representative Fine has implied that the organizations are liars with a motive to simply make more money and “mutilate children.”
