Court settlement: Georgia Medicaid must fund gender-reaffirming care



The state of Georgia has agreed in a court settlement to fund gender-reaffirming medical care through the state’s Medicaid program. Medicaid, the health insurance program for poor children and some disabled and elderly adults, is funded jointly by the state and federal governments.

The state signed the settlement following court-ordered arbitration, after two transgender women, aged 45 and 60, sued in 2021 because Georgia Medicaid would not pay for the medical care they needed and which they said was required by law.

The state Department of Community Health also agreed to pay $350,000 as part of the settlement.

Gender-reaffirming care may include taking hormones or surgery to physically transition the patient’s body to the opposite sex.

Each of the two plaintiffs, born physically male, said they had known they were female since they were children. The settlement means both plaintiffs will be able to obtain surgery to complete their transition to female.

Patients who don’t get gender-reaffirming care may have gender dysphoria, a condition of distress at the non-alignment of their physical sex with their perceived gender. Gender dysphoria contributes to the unusually high rate of suicide among trans people, with 40% having attempted suicide, according to studies.

“We know that gender-affirming care is medically necessary care,” Eric Paulk, deputy director of Georgia Equality, said in a press statement.

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“Denying necessary health care because an individual is transgender is discriminatory and unconstitutional,” echoed Nneka Ewulonu, a staff attorney with the American Civil Liberties Union of Georgia, which worked on the case.

Credit: Courtesy of the ACLU

Credit: Courtesy of the ACLU

“This settlement will give low-income transgender Georgians on Medicaid — who are disproportionately likely to be Black — access to gender-affirming care for the first time in over 20 years,” Ewulonu said. “We are thrilled for our clients and the transgender community in Georgia.”

The Department of Community Health said it had no comment on the settlement.