Transgender Surgeries: Guess Who’s Paying for Them

New York Medicaid expansion will cover reassignment treatment for kids and teens

In a shocking turn of events, the New York state health department announced Wednesday the state Medicaid program would begin covering gender transition care to youth experiencing gender dysphoria. The condition is defined as the distress a person experiences as a result of the sex or gender under which they were born.

Previously, the health department had kept to a 1998 policy that refused coverage for cosmetic transitional treatment, including cross-sex hormone therapy and surgeries. The department removed that policy for adults in March 2015 — but coverage remained restricted for teenagers and young children.

Taxpayers in Kentucky, Texas, and Virginia will also be contributing to transitional treatments for New York teens.

Now children as young as 11 or 12 years old can begin receiving hormone therapy, on the taxpayer’s dime, that forestalls puberty. The hormone therapy costs as much as $1,500 a year, not including the cost of $30,000 or more for gender reassignment surgery. “This is outrageous, and naturally the New York taxpayer winds up paying for this in one way or another,” said a New York resident and father of four.

But the responsibility for this cosmetic smorgasbord of treatments goes even further. Medicaid is jointly funded by state and federal money. The federal government pays states for a specific percentage of Medicaid costs in a program called the Federal Medical Assistance Percentage (FMAP). This means that taxpayers in Kentucky, Texas, and Virginia will also be contributing to transitional gender treatments for New York teens.

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“This is a powerful example of why Medicaid needs fundamental reform,” said Brian Blase, senior research fellow at the Mercatus Center at George Mason University in Washington, D.C. “There is no doubt that people across the country have very different opinions on this. States should be allowed to make different decisions; however, a state should not be able to pass the costs of a decision to expand Medicaid to cover transgender surgery to people outside of the state.”

He added, “Taxpayers in Kansas, Alabama, Oregon, etc. — who may feel very differently on this issue than people in New York — should not be responsible for financing New York’s decision. Reform that replaces the current federal open-ended reimbursement structure with fixed payments to states would mean that New York would internalize the cost of this controversial decision.”

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The medical community is far from reaching a consensus about the benefits of chemically castrating transgender children with hormone therapy.

“Puberty is not a disease, and puberty-blocking hormones can be dangerous. Reversible or not, puberty-blocking hormones induce a state of disease — the absence of puberty — and inhibit growth and fertility in a previously biologically healthy child,” said doctors at the American College of Pediatricians, a nonprofit organization based in Gainesville, Florida, in a media release on transgender youth. The ACP group comprises pediatricians, endocrinologists, and psychiatrists who research medical issues affecting children and families and work to influence policy.

Related: Radical Transgender Policy Hits New Hampshire School

They added that cross-sex therapy increases the risk for “high blood pressure, blood clots, stroke, and cancer” — and that delaying puberty can “cause infertility, stunted growth, low bone density, and an unknown impact upon their brain development.”

Never mind that children electing to have these procedures are young — and may changes their minds.

The doctors assert these children and teenagers have a limited ability to make the decisions because the pre-frontal cortex — the portion of the brain in charge of logic and risk-assessment — hasn’t finished developing, and won’t, until their mid-twenties.

“Never has it been more scientifically clear that children and adolescents are incapable of making informed decisions regarding permanent, irreversible and life-altering medical interventions.”

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