Alex Bollinger

Eighteen state attorneys general signed a brief asking a federal judge in Florida to allow states to ban gender-affirming care for transgender people from being covered under state Medicaid programs, using inflammatory language to explain why trans people shouldn’t have equal access to health care.

Last year, the Florida Agency for Health Care Administration (AHCA) finalized a rule banning healthcare providers from billing the state’s Medicaid program for trans people’s gender-affirming care, a rule that covered puberty blockers, hormone therapies, and surgical procedures for adults. Medicaid is a joint federal and state program providing healthcare coverage for low-income people.

Related:

Four trans people and their families sued in federal court for access to needed health care and U.S. District Court Judge Robert Hinkle invalidated AHCA’s rule this past June with a scathing 54-page opinion. “Gender identity is real,” Hinkle wrote, accusing AHCA of making the rule “for political reasons.”

Get the Daily Brief

The news you care about, reported on by the people who care about you:

“Pushing individuals away from their transgender identity is not a legitimate state interest,” Hinkle wrote.

Florida is appealing the decision to the U.S. Court of Appeals for the Eleventh Circuit. Eighteen Republican attorneys general from other states signed a briefsupporting Florida, arguing that doctors are greedily pushing gender-affirming care on people to make money, including the doctors who work for national medical organizations like the American Academy of Pediatrics and the Endocrine Society, which all support access to gender-affirming care for transgender people. The brief’s point was that Judge Hinkle relied on the research of the medical organizations and heeded their opinions more than the odd doctors Florida was able to find to say that trans people don’t need gender-affirming care. 

“Medical interest groups, composed of physicians self-interested in Medicaid coverage, are not neutral arbiters of ‘medical opinion,’” the Republicans wrote, accusing the organizations of stifling debate.

The argument is similar to one that AHCA made in the original case that Hinkle rejected, calling it “fanciful to believe that all the many medical associations who have endorsed gender-affirming care… have so readily sold their patients down the river.”

In June, Hinkle ruled that AHCA’s rule violates the federal Medicaid statute, the Equal Protection Clause of the Fourteenth Amendment, and the Affordable Care Act. He also ordered the state to cover gender-affirming care for transgender people on the state’s Medicaid program.

“I am extremely relieved,” said August Dekker, a 29-year-old transgender man and the lead plaintiff in the case. “Florida’s policy effectively denied me the treatment my doctors recommended,” he said. “Now access to that lifesaving, critical care can continue.”

Advocacy groups estimate that 9,000 transgender people in Florida use Medicaid to fund their treatments.

The states that signed the brief are Alabama, Arkansas, Tennessee, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Mississippi, Missouri, Montana, Nebraska, South Carolina, Texas, Utah, Virginia, and West Virginia.

The U.S. Court of Appeals for the Seventh Circuit has ruled in favor of three transgender students who were forbidden by their schools from using bathrooms matching their gender identities. The circuit court upheld a lower court’s preliminary injunction that said the schools have to let trans students use facilities associated with their genders. 

“Students who are denied access to the appropriate facilities are caused both serious emotional and physical harm as they are denied recognition of who they are,” said ACLU of Indiana lawyer Kenneth Falk. “They will often avoid using the restroom altogether while in school. Schools should be a safe place for kids and the refusal to allow a student to use the correct facilities can be extremely damaging.”

The case involves three trans boys in Martinsville, Indiana and Terre Haute, Indiana, who need access to the boys’ room at their middle and high schools. 

One of the boys, identified as A.C. in court documents, is 13 and knew he was a boy since age eight. When he started seventh grade at John R. Wooden Middle School, his stepfather asked that he be allowed to use the boys’ rooms. The school refused and said that A.C. has to use either the girls’ room or a unisex bathroom in the health clinic.

Since he wasn’t out as trans to his classmates, he didn’t want to use the girls’ room. The only accommodation he got was that he wasn’t punished for tardiness when he used the health clinic bathroom. The school suggested he go entirely to online classes just to keep him out of the boys’ restroom. 

He felt “depressed, humiliated, and angry” at school and tried to avoid going to be bathroom, which became a major distraction. 

The school district actually had a policy to allow some trans students to use the appropriate bathrooms at the district high school, but they told him they couldn’t accommodate him because he’s in middle school.

The other two plaintiffs are 15-year-old twins B.E. and S.E. at Terre Haute North Vigo High School, who both transitioned socially when they were 11. They both also have a colon condition that requires them to take laxatives and have regular access to bathrooms.

They started using the boys’ restrooms in 2021 and no students had a problem with them doing so, the court documents say. But school employees who knew they were trans admonished them. Their mother met with the vice principal, and she was told that the twins had to use the girls’ facilities or a bathroom in the health office.

Since they weren’t out as trans at school, they worried about upsetting the other girls by using the girls’ facilities, and the health office was often locked during parts of the day and far away. B.E. had an accident once because he couldn’t get to the health office in time.

The school’s transgender bathroom policy took numerous factors into consideration and the school’s administration said that trans students needed unspecified surgical changes before they could use the correct bathroom. Gender-affirming surgery is banned for trans people under the age of 18 in Indiana.

The court took into account the fact that Title IX bans discrimination on the basis of sex in schools that receive federal money, which is most of them. Citing the 2020 Supreme Court decision in Bostock v. Clayton Co. that found that job discrimination against LGBTQ+ people necessarily takes sex into account and is therefore prohibited under Title VII, the appeals court ruled that the trans boys are likely to succeed in their case and that preventing them from using the correct bathroom while the case works its way through the court system could cause irreparable harm.

“Litigation over transgender rights is occurring all over the country, and we assume that at some point the Supreme Court will step in with more guidance than it has furnished so far,” Judge Diane Wood wrote for the court in her opinion.

A library in Montana has canceled a transgender Cheyenne woman guest speaker, saying that her appearance at the library could violate the state’s new drag ban.

Adria Jawort – who made headlines last year when she won a lawsuit against a conservative, straight, white male pastor who called her mentally ill – was set to speak at the Butte Public Library last Friday as part of the library’s Pride Month programming. She was going to speak about “Montana History of Two-Spirit and LGBTQ+ Peoples.”

But the library canceled her appearance on Thursday afternoon. A librarian emailed her and said that the county “decided that it is too much of a legal risk to have a transgendered person in the library. I really regret this.”

Butte-Silver Bow city-county Chief Executive J.P. Gallagher cited the state’s new law, H.B. 359, which is intended to ban drag story hours. The law bans both drag queens and kings from reading in front of children. It also defines both as “a male or female performer who adopts a flamboyant or parodic” male or feminine persona “with glamorous or exaggerated costumes and makeup.”

Gallagher still proclaimed June Pride Month at the Butte-Silver Bow Courthouse that same day. 

Gallagher said that he would have let the performance happen if not for the state law. “But we would be in violation of state law if we allowed this person to give her presentation,” he said. According to Jawort’s Substack, Gallagher was reportedly getting legal advice from County Attorney Eileen Joyce.

Jawort said that she testified in the state legislature against the drag ban.

“I did so by explicitly doing a little dance (it was the beginning of the dance by that robot girl in the M3GAN) and saying that this bill’s broad definition targets trans people, what I had just done would be illegal under it,” she wrote. “Then I explained First Amendment Law to them – which seemed to be beyond their comprehension.”

Jawort said that there was already going to be a police presence at her lecture on Friday because the library “had been receiving harassing calls” about it.

“Now, what we have here is like a version of 21st Century ‘masquerade laws’ used to target trans people with back in the 1950s and 60s with [SIC] to arrest them for wearing articles of clothing of the opposite ‘biological’ gender,” she wrote.

“I have never had this happen before,” Butte Library librarian Shari Curtis told the Montana Standard. “The Butte Public Library supports free speech and our LGBTQ+ community, but the county leadership overruled us.”

In 2021, pastor J.D. Hall, a former darling of the far-right wing in Montana, called Jawort a “Gothic Transvestite,” called her “mannish,” and said she was mentally ill because she is trans. He also said that she threatened state officials.

She sued him for libel and they reached a settlement involving Hall paying Jawort $250,000, retracting the libelous article from his website, and publicly apologizing to Jawort.

“I apologize to Adrian Jawort,” Hall’s public apology in 2022 said. “The information I published about Adrian was false. Adrian did not threaten or harass Senator Butch Gillespie. I regret the error and sincerely apologize to Adrian for publishing it.”