Medicare Coverage for Gender-Affirming Healthcare Saves Trans Lives

The topic of transgender rights has rapidly become hotly contested talking point in national and global politics within the last decade. In Florida, policies related to transgender issues, especially those affecting transgender minors, have sparked intense debate.

Policies restricting participation in youth sports by transgender players, preventing discussion of LGBTQ+ identities in classrooms and penalizing doctors who provide gender-affirming care for underage patients have all been passed by Florida legislators within the last two years alone.

Although the policies have the potential to seriously harm the mental and physical health of LGBTQ+ youth, Republican legislators have justified these restrictions on the basis that children do not have the mental capacity to fully understand queer topics or consent to dangerous and permanent medical and social transition procedures despite the insistence of medical professionals that any gender-affirming medical care provided to children is reversible and relatively low-risk.

While this argument directly contradicts scientific consensus about the benefits of gender-affirming care for transgender children and teenagers, it gives lawmakers the ability to claim that their goal is to protect the autonomy of children.

Photo credit: Julia Monteiro Martins

Now, however, the emboldened conservative Florida government has cast aside the veneer of concern for bodily autonomy by taking measures to prevent adults from accessing this life-saving treatment as well. On Aug. 11, Florida governor Ron DeSantis’s administration passed a state rule denying Medicaid coverage for gender-affirming procedures such as hormone replacement therapy.

The policy, which took effect Aug. 21, was passed on the basis that there is no compelling evidence that such procedures are life-saving, so they are therefore not medically necessary. This is a lie.

A 2022 study by the University of Washington found that access to medical procedures such as puberty blockers and hormone replacement therapy decreases rates of depression by 60% and risk of suicidal ideation by 73% in transgender and non-binary adolescents. Similar conclusions are shared by other reputable medical institutions, such as the American Association of Pediatrics, the American Psychological Association and the American Medical Association.

By ignoring the cohesive scientific consensus on this issue, Florida lawmakers are engaging in science denial for the sole purpose of enacting bigotry.

Now that this law is in effect, transgender citizens will need to either pay medical insurance or pay out of pocket in order to access these life-saving procedures.

Unfortunately, transgender Americans have a poverty rate of 29%, according to the 2015 U.S. Transgender Survey conducted by the National Center on Transgender Equality. This is more than twice the national average poverty rate of 14%. The survey also shows that poverty rates are even higher for transgender people of color.

This means that without Medicaid coverage, access to gender-affirming care is virtually impossible for a large percentage of patients and with healthcare costs steadily increasing, it will also likely become difficult for transgender Americans living above the poverty line to access these procedures.

It is not an exaggeration to say that the removal of Medicaid coverage for gender-affirming healthcare, as well as the plethora of other policies contributing to the oppression of transgender children and adults, will directly lead to increased rates of depression and suicide among Florida’s transgender population.

The LGBTQ+ community and their allies must make their voices heard through protest and through voting against lawmakers who will enact this bigoted legislation in November’s midterm elections. On a local level, allies should spread the word about other avenues through which their transgender community members can access necessary healthcare.

Until this policy is changed, transgender Floridians can contact nonprofit organizations The McKenzie Project, TransSOCIAL and Point of Pride for assistance in accessing gender-affirming hormone therapy and surgeries at a lower cost. Some Planned Parenthood locations also offer hormone therapy at lower rates.

Kris Berg is a senior majoring in English literature and print journalism. They are originally from Westchester, N.Y. and aspire to live and work in New York City after graduation.