Gender-affirming health care will soon become a covered benefit for Alaskans on Medicaid.
The change is the result of a settlement in a lawsuit filed against the state health department that challenged the legality of excluding transgender Alaskans from health coverage related to their gender transitions.
Last year, three Alaskans sued the Alaska Department of Health and Social Services Commissioner Adam Crum and the department, arguing the state’s refusal to cover transition-related health care was a civil rights violation.
A settlement in the case was reached early this year. It stipulated an end to previous exclusions of gender-affirming health coverage — including “treatment, therapy, surgery, or other procedures related to gender reassignment,” and for “transsexual surgical procedures or secondary consequences” — from the state Medicaid plan. This week, the state posted a public notice reflecting those policy changes, which are scheduled to go into effect July 25.
The 2020 lawsuit was an amended version of one filed in 2019. At the time, Alaska was one of less than a dozen states with a Medicaid program that explicitly excluded coverage for gender-affirming care.
Gender dysphoria is classified by the Diagnostic and Statistical Manual of Mental Disorders as “the clinically significant distress or impairment in social, occupational, or other areas of function associated with the incongruence between a transgender person’s gender identity and assigned sex.”
The lawsuit described incidents where the three plaintiffs — Swan Being, Robin Black and Austin Reed — sought care and were told that Alaska Medicaid would not cover it.
Being is a Homer woman in her early 70s who was medically diagnosed with gender dysphoria and had been living as a woman for more than five years, according to the lawsuit.
Although her doctors had recommended she continue to receive medical treatment related to her hormone levels, the lawsuit stated that she received a notice from a contractor for the state that said “hormonal injections and lab work associated with gender reassignment is not a covered benefit under Alaska Medicaid.”
Black and Reed report similar experiences in the lawsuit: Both were denied coverage for different surgical procedures meant to treat their diagnosed gender dysphoria, their attorneys wrote in the lawsuit.
Carl Charles, an attorney with Lambda Legal, was one of the lawyers representing the plaintiffs alongside the Northern Justice Project, a local law firm. His team helped win a recent ruling in Alaska in which a federal judge sided with a transgender state employee who sued the state on a similar allegation of health care discrimination.
“Transition-related health care is essential health care,” Charles said in an emailed statement Monday. “This is a significant step toward ensuring the health and safety of all transgender Alaskans.”
A spokesperson from the Alaska Department of Health and Social Services said in an emailed statement Tuesday morning that the settlement and recent regulation amendments were a result of the Affordable Care Act and a recent U.S. Supreme Court decision, Bostock V. Clayton Country.
Editor’s note: This story has been updated to clarify a quote by Carl Charles and add a statement from the Alaska Department of Health and Social Services on Tuesday morning.