Appeals Court Confronts Medicaid Gender-Affirming Care Exclusion

Low-income transgender people in West Virginia asked the Fourth Circuit on Tuesday to help ensure that they’ll be able to get medically necessary gender-affirming surgeries by requiring Medicaid to pay for them.

They were met with skepticism by Judges Julius N. Richardson and Allison Jones Rushing, who appeared to be convinced by the state’s argument that the exclusion is justified because it’s based solely on a diagnosis of gender dysphoria, not a patient’s transgender status.

Judge Diana Gribbon Motz was more focused on the medical procedures in question, asking why Medicaid coverage is different based on whether the patient is ...