Yale University rebukes Florida’s plan to deny trans treatment under Medicaid

A group of Yale University professors are fighting a DeSantis administration plan that would deny Medicaid insurance coverage for treatments, including puberty blockers and hormone therapy for low-income transgender people from Florida.

In a 28-page report released by Yale Law School and Medical School, researchers at the Ivy League institution chastised the controversial plan and called it a “discriminatory policy” based on “pseudo-science “. Texas Southwestern and the University of Alabama also contributed to the “critical review”.

“Florida’s proposed denial of Medicaid benefits for gender-affirming care discriminates against the poorest and most vulnerable segments of the population who have no other source of health care coverage. than Medicaid and lack the resources to venture out of state,” said Dr. Hussein Abdul-Latif, professor of pediatric endocrinology, University of Alabama at Birmingham.

Florida state health officials argue that puberty-blocking drugs, cross-sex hormones and sex reassignment surgery for transgender people should not be covered by Medicaid because these treatments have not been proven safe or effective.

They also argue that these treatments do not meet the definition of a “medical necessity,” a key requirement because, by law, Medicaid services must be considered medically necessary. The state’s position was exposed last month when state health officials released a lengthy report on the matter.

After:DeSantis’ plan to deny trans Medicaid treatment leads to noisy hearing

“We are alarmed that the Florida Health Agency has adopted a purportedly scientific report that so flagrantly violates fundamental principles of scientific inquiry,” the report’s authors write. “The errors of the June 2 report are so repeated and fundamental that it seems clear that the report is not a serious scientific analysis but rather a document designed to serve a political agenda.”

Medicaid for at-risk Florida transgender youth under Governor DeSantis

The Yale faculty review features a lengthy critique of the state’s position. Among other objections, the authors accuse Florida of rejecting “sound medical research” and making policy decisions based on a “misunderstanding” of medical and scientific research.

The review categorically defends the medical treatment of gender dysphoria as “meeting” medical standards and backed by “sound scientific consensus”.

The review’s authors also criticized the plan as illegal under state and federal laws, arguing that such a proposal targets transgender Floridians, not cisgender residents.

Florida pushes back

In a statement to USA TODAY – Florida, the Agency for Health Care Administration (AHCA) – which will soon make a decision on the matter – unreservedly reprimanded Yale’s findings.

“This is just another example of the left-wing academic propaganda machine arrogantly demanding that you follow their words and not the clear, evidence-based science that is right in front of you,” the director of science said. AHCA communications, Brock Juarez, in an email. “The Yale ‘review’ is a hodgepodge of baseless claims using ‘expert opinions’ that lack any kind of real authority or scientific credibility.”

In the email, the AHCA defended the credibility of its report and highlighted studies that suggest research into treatments such as puberty blockers and hormone therapy are “very weak” and often without randomized controlled trials – a factor the state considers the “gold standard” for finding new treatments. The state agency also noted the lack of long-term follow-up studies after sex reassignment surgery.

“We stand firmly by our five reports based on evidence, rather than eminence, from subject matter experts, including healthcare researchers who have studied the quality of evidence on which the healthcare machine stands. supports for ‘gender-affirming’ care,” Juarez added.

DeSantis vs. the White House

The AHCA’s impending ruling is among the latest hot political issues DeSantis has championed since he was sworn in as governor in 2019 following a slim election victory. Across Florida and across the country, his decisions were hailed by many conservatives, while lambasted by many progressives. He is widely considered one of the top Republican presidential candidates of 2024.

Last year, he signed a controversial bill – the Women’s Sports Equity Act – which banned transgender athletes from competing in women’s and women’s sports. Democrats and LGBTQ+ activists have chastised the measure as harmful and discriminatory. Republicans, meanwhile, argue that the law preserves athletic integrity.

More recently, DeSantis proclaimed Sarasota native Emma Weyant the “legitimate winner” of the NCAA Women’s 500-yard Freestyle Swimming Championship – after losing to a transgender opponent.

The White House, among other elected critics, is fighting back. Last month, President Joe Biden issued an executive order to thwart what his administration calls discriminatory legislative attacks on the LGBTQ community by Republican-controlled states, including Florida.

The order aims in part to promote gender-affirming surgery for gay and transgender parents and children and pushes to ease barriers to health care and certain types of treatment for the LGBTQ community.

Yale’s Florida report is the second of its kind this year. They previously filed a similar report in Texas and Alabama in an effort to challenge “discriminatory laws” based on “abused” science.”

“Florida’s illegal attempt to deny transgender people standard medical care is the latest in a wave of anti-trans medical bans,” said Yale Law School professor Anne Alstott. “We were appalled that the state ignored real science and instead relied on biased and misleading evidence.”

According to the Human Rights Coalition, lawmakers across the country introduced more than 130 bills addressing transgender rights in 2022 alone.

Jason Delgado is a reporter for the USA Today Network-Florida. He is based in Tallahassee. Contact him at [email protected]

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