Kelcie Moseley-Morris

(Idaho Capital Sun) Two Idaho residents have filed a federal lawsuit against the Idaho Department of Health and Welfare alleging discriminatory policies for denying transgender individuals Medicaid coverage for gender reassignment surgery, according to the complaint.

The transgender women go by TB and MH in the court documents and are 18 and 21 years old, respectively. They have requested that the court allow their names to be sealed in court records to protect them from harassment, threats or acts of violence.

Idaho Legal Aid Services attorney Howard Belodoff is representing the individuals, and the complaint names Department of Health and Welfare Director Dave Jeppesen and Idaho Medicaid Medical Director Dr. Magni Hamso.

Niki Forbing-Orr, spokesperson for the Idaho Department of Health and Welfare, said the department does not comment on pending or current litigation.

Idaho Medicaid is a health insurance program jointly funded by the state and the federal government that provides medical coverage to eligible low-income residents. The Department of Health and Welfare manages the state Medicaid program.

According to a press release about the complaint, the named officials have enforced a policy of unreasonably delaying and denying authorization for treatment of gender dysphoria. Gender dysphoria is known as the distress that a transgender person experiences by having a gender identity that conflicts with the sex they were assigned at birth, according to the Mayo Clinic. The symptoms of dysphoria can be resolved through genital reconstruction surgery, the complaint says.

“While cisgender people receive the same or similar health care as a matter of course, defendants Jeppesen and Hamso refuse to cover the identical care for transgender Medicaid beneficiaries, under a policy of characterizing gender-affirming surgery as ‘cosmetic’ and not medically necessary,” the complaint states.

Belodoff wrote in the complaint that the policy is discriminatory and in violation of the provisions of the Medicaid Act, the Affordable Care Act, and the equal protection and due process clauses of the 14th Amendment.

Parent of one Idaho plaintiff worries further delay will increase suicidal risk

According to the complaint, 17 months have passed since the 21-year-old plaintiff identified as MH requested coverage for surgery that her providers said is medically necessary. The department, according to the complaint, has not provided a final decision or opportunity for a hearing to challenge the denial or delay.

The complaint states the 18-year-old plaintiff identified as TB was told the department considered her surgery cosmetic, despite her health care providers stating it was medically necessary. The department has not granted a hearing to appeal the denial more than four months later, it says.

The parent of TB submitted a supporting statement saying between the ages of 11 and 12, TB was twice admitted to mental health facilities “due to not wanting to live in the world where she could not be true (to) herself.”

“The long delay in receiving Medicaid approval for her gender affirming surgery has made TB very mentally fragile and I am afraid she will once again lose hope and attempt to take her life,” the statement said.

The parent, whose is unnamed, said TB has already experienced bullying in high school and in other areas of her personal life and said some people in their community have said transgender people are “evil” and “just want attention.”

“There are local Idaho legislators and government officials who have openly supported discrimination against transgender people and are against providing them with legal protections against discrimination in health care, employment and housing,” the parent wrote. “The atmosphere fostered in my community by these officials make us feel we don’t belong in Idaho, and they don’t care about TB’s and our well-being and safety.”

Response from state defendants is required by Oct. 20

The complaint asks the court to prohibit any further enforcement or application of the alleged practices and to enter a declaratory judgment that the plaintiffs have been discriminated against on the basis of sex, including gender identity, sex stereotypes and sex characteristics. It also asks for an unspecified amount of compensatory damages to be paid to the individual women, along with attorneys’ fees.

The defendants are required to respond by Oct. 20, according to federal court records. The case has been assigned to Magistrate Judge Raymond Edward Patricco Jr.