Until this month, Medicaid paid for August Dekker's testosterone treatments which allowed the transgender man from Florida's Gulf Coast to feel like he was living in his own skin. But now he is scrambling to figure out how to pay for future treatments since Florida last month started restricting Medicaid insurance coverage for gender affirming care for transgender people.
Dekker and three other plaintiffs on Wednesday sued Florida health officials, claiming the rule change was unconstitutional.
"This is the care that has been recommended by my doctors. Taking away our medical care is wrong and hurtful," said Dekker, 28, who lives in Hernando County, about 50 miles (80 kilometers) north of Tampa.
The lawsuit filed in federal court in Tallahassee says the rule change will have dire emotional, physical and psychological consequences for transgender Medicaid beneficiaries in Florida if it's allowed to stand. The rule change violates the equal protection clause of the Fourteenth Amendment, the patient protection section of the Affordable Care Act and the Medicaid Act, said the lawsuit which seeks an injunction to stop its continued implementation.
The Florida Agency for Health Care Administration previously released a report stating that puberty blockers, cross-sex hormones and sex reassignment surgery have not been proven safe or effective in treating gender dysphoria, a position disputed by the American Medical Association and many doctors and mental health specialists.
In an email, Brock Juarez, the Florida agency's communications director, described the lawsuit as motivated by "partisan" groups "so blinded by their own political agenda that they ignore the evidence found in our thorough rulemaking process and in the AHCA report that proceeded it."
"Under our rules, only treatments that are found to be safe, effective, and that meet medical necessity criteria may be covered," Juarez said.
Last year, the American Medical Association issued a letter urging governors to block any legislation prohibiting the treatment, calling such action "a dangerous intrusion into the practice of medicine." The letter noted that medical treatments are among several "supportive interventions" promoted for transgender minors.
Only eight other states have restrictions on Medicaid insurance coverage for gender affirming care, and that number had been decreasing, said Carl Charles, a senior attorney for Lamba Legal, one of several advocacy groups that filed the lawsuit on behalf of the plaintiffs.
"This is a 180 for Florida and this is particularly troubling because they have been covering this for Medicaid for years," Charles said.
Critics say the rule change is only the latest anti-transgender measure taken by the administration of Republican Florida Gov. Ron DeSantis, who is up for reelection this year and touted as a possible GOP candidate for president in 2024.
Earlier this year, his administration issued guidance that pushed back against federal guidelines by opposing gender reassignment surgery for children and adolescents and puberty blockers for anyone under 18. Last year, DeSantis signed a law barring transgender girls and women from playing on public school teams intended for student athletes identified as girls at birth.
Besides Dekker, the plaintiffs in the lawsuit include a 20-year-old transgender man from the Fort Lauderdale area who goes to college in Orlando; a 12-year-old transgender girl from Florida's Space Coast; and a 12-year-old transgender boy from the Sarasota area. The minor plaintiffs were represented in the lawsuit by their parents.
Jade Ladue, the mother of the 12-year-old boy, said he was taking medication that delayed puberty and allowed him to avoid the emotional harm of being a sex he did not identify with. She said her family was contemplating moving out of state if her son can't get his treatment.
"He always was a boy. It was never a choice for him," Ladue said. "We are extremely worried about this and what will happen to him. We want the best for our child."