Trans women sue to overturn Georgia Medicaid ban on surgery

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Two transgender women are suing to end the state’s ban on gender-affirming healthcare in the Georgia Medicaid program, an exclusion they argue is unconstitutional and violates federal law.

The federal lawsuit by Delshone Thomas and Gwendolyn Cheney was filed Thursday. It seeks a permanent injunction against the Georgia Department of Community Health, which administers the state’s Medicaid program, from continuing its 28-year-old ban on gender-affirming surgeries. It also seeks class-action status for any transgender Georgian denied care under the ban. 

“Ms. Thomas and Ms. Cheney have each been denied health care because of Georgia’s unconstitutional and unlawful ban on gender-affirming care for transgender people,” Taylor Brown, staff attorney with the ACLU LGBTQ & HIV Project, said in a press release. 

“If they were not transgender, Georgia Medicaid would cover the procedures they seek. This is discrimination and it is against the law. At a time when many in our country are having long-overdue conversations about racial disparities in our health care system, it is important that the health care needs of Black transgender people, like Ms. Thomas and Ms. Cheney, are a part of that conversation,” Brown added.

The ACLU filed the lawsuit along with attorneys from the Atlanta, Chicago and Washington, D.C., offices of King & Spalding. The Atlanta-based law firm routinely notches top scores on HRC’s Corporate Equality Index for its LGBTQ-inclusive policies. 

Georgia is one of 11 states that prohibit Medicaid programs from providing gender-affirming care to trans people, according to the Movement Advancement Project. If the lawsuit is granted class-action status, it could impact some 5,000 trans Georgians in the program, according to the ACLU.

Gender-affirming care to treat gender dysphoria may include hormone therapy and surgical procedures to align a trans person’s sex with their gender identity. If left untreated, gender dysphoria can result in mental health issues, suicidality, discrimination and victimization.

Thomas, 45, is disabled and lives in Riverdale. She has identified as female since the age of seven and faced an unsupportive family that reacted to her transition with “a great deal of physical violence, verbal violence, and discrimination in all facets of life because of her gender identity,” according to the lawsuit. 

“Not having access to health care has made me really depressed because it’s like down here in the South, we are only tolerated not accepted,” Thomas said in a prepared statement. “Even when it comes to health care, we are only given the bare minimum to exist. It keeps me depressed, I think about it all the time, and it feels like there is no way out.”

She was diagnosed with gender dysphoria around 2014 and began hormone therapy. Her healthcare providers recommended gender-confirming surgeries in 2019 but Georgia Medicaid wouldn’t authorize it. Thomas said she can’t afford the out-of-pocket cost of the procedures.

Cheney, 60, is a Georgia native who lives in Athens. She’s identified as female since the age of 12 and was diagnosed with gender dysphoria around 2014. Cheney receives hormone therapy and needs gender-affirming surgeries but can’t afford the cost. Without the surgeries, she fears being harmed when she leaves her home and has experienced physical violence and discrimination for being transgender, according to the lawsuit.

“Oftentimes I have felt like giving up because I do not feel complete,” Cheney said in a prepared statement. “I don’t feel like who I know I am. It has stopped me from living a full life. My life has not been a free one, it has been hard and difficult. I don’t want to just exist. I want to live.”

Gender-confirming healthcare is routinely covered by private and public insurers, according to the lawsuit. The federal Medicare program has covered it since 2014.

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