Removing the Constraints to Coverage of Gender-Confirming Healthcare by State Medicaid Programs

True, Nicole M.
May 2012
Iowa Law Review;May2012, Vol. 97 Issue 4, p1329
Academic Journal
In April of 2010, the United States Tax Court in O'Donnabhain v. Commissioner held that sex reassignment surgery and hormone therapy are tax-deductible medical expenses under the Internal Revenue Code. In the course of reaching its decision, the court found that sex reassignment surgery is a medically necessary treatment for gender identity disorder and that the medical community generally agrees that sex reassignment is both an appropriate and effective treatment for gender identity disorder. While these findings were reached in a case interpreting the Internal Revenue Code, they still have the potential to influence whether these forms of treatment are covered under the Federal Medicaid Act. Currently, individuals diagnosed with gender identity disorder face a great deal of difficulty getting Medicaid or private insurance to cover most gender-confirming treatment, particularly sex reassignment surgery. This Note focuses on state Medicaid coverage of sex reassignment surgery and other gender-confirming healthcare and argues that courts reviewing denials of coverage for these treatments should adopt the findings in O'Donnabhain. Further, this Note argues that states with regulatory and statutory provisions explicitly excluding coverage of sex reassignment surgery and other gender-confirming healthcare should repeal them or, in the alternative, that the courts in these jurisdictions should judicially invalidate these provisions because they no longer comply with the requirements imposed by the Federal Medicaid Act.


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