West Virginia Medicaid Must Cover Trans Surgery, Judge Rules
sued the state in 2020 on behalf of trans West Virginians, challenging the exclusion of such care from Medicaid and from the state employee health insurance plan.
A settlement reached earlier this year led to the lifting of coverage restrictions from the state employees’ plan, and now Medicaid will cover this care too.
Medicaid is a joint federal-state health insurance program, administered by each state, primarily for low-income people.“The same or similar surgical treatments are available to persons when the diagnosis requiring that treatment is not gender dysphoria,” U.S.
District Judge Robert C. Chambers wrote in his decision. The exclusion for treatment of gender dysphoria “invidiously discriminates on the basis of sex and transgender status,” he continued.The named plaintiffs in the suit were Christopher Fain and Shauntae Anderson, but the suit has class-action status, so the ruling will affect all trans West Virginians covered by Medicaid.“This is a victory not only for me but for other transgender Medicaid participants across West Virginia,” Fain said in a Lambda Legal press release. “This decision is validating, confirming that after years of fighting to prove that gender-confirming care is medically necessary, we should have access to the same services that West Virginia Medicaid already provides to cisgender participants.
