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Group Fights Minn. Transgender Surgery Ban

MINNEAPOLIS (CN) - Minnesota's ban on reassignment procedures for gender dysphoria is discriminatory and is condemned by the medical community, a rights group claims in court.

Gender dysphoria is the medical diagnosis for people who do not identify with the sex they are assigned at birth, according to a lawsuit filed Thursday in Ramsey County, Minn.

OutFront Minnesota, OutFront Minnesota Community Services and Evan Thomas sued Emily Piper, commissioner of the Minnesota Department of Human Services, alleging discrimination based on medical diagnosis, transgender status and sex.

While public health programs Minnesota Medical Assistance and MinnesotaCare provide coverage for any type of medical condition, Minnesota has banned coverage for gender reassignment procedures, OutFront claims.

"But for gender dysphoria, [state law] mandates a sweeping and categorical exclusion of all transition-related surgical care without any regard to whether the treatment is medically necessary for an individual recipient, " the lawsuit states.

OutFront says that, because of the prohibition, treatments for gender dysphoria like hysterectomies and mastectomies are excluded from coverage even though the same treatments are covered for Minnesota Medical Assistance recipients to treat other serious conditions.

"These discriminatory exclusions of healthcare for gender dysphoria have no basis in medical science and have been condemned by every leading medical group," the complaint states.

According to OutFront, Minnesota provided Medical Assistance coverage for medically necessary transition-related care, including surgery, from 1977 until 1998 without statutory restriction.

But, in 1995, the state legislature amended the General Assistance Medical Care program, which is separate from the Minnesota Medical Assistance program, to eliminate funding for transition-related surgery.

By 1998, the legislature amended the Medical Assistance statute to exclude coverage for gender reassignment surgery, including drug therapy for gender reassignment, according to OutFront's lawsuit.

In 2005, the legislature amended the statute again to remove the ban on coverage for drug therapy and the statute was changed to say, "sex reassignment surgery is not covered," the complaint states.

OutFront claims the decision to exclude coverage "was not based on any determination that the treatments were experimental or not medically necessary."

Instead, the Minnesota Department of Human Services "urged the legislature to change the language because it was concerned that the assertion that transition-related surgery is not medically necessary could not be successfully defended in court," the group claims.

Thomas, a 63-year-old transgender man, claims he sought assistance from the University of Minnesota Center for Sexual Health in 2013 to cope with his increased depression related to his gender identity.

After he was diagnosed with gender dysphoria, Thomas says he began receiving testosterone hormone therapy in March 2013. Earlier this year, he was granted a legal name and gender change, the lawsuit states.

Thomas' testosterone hormone therapy has helped with his depression, but his breasts are "incongruent with his full-time masculine presentation," he claims in the complaint.

Blue Cross Blue Shield denied a request for Thomas to have chest reconstruction surgery earlier this year, citing Minnesota state law banning gender reassignment procedures, according to the lawsuit.

Teresa Nelson, legal director of the American Civil Liberties Union of Minnesota, said in a statement that denying such healthcare services "is harmful and discriminatory."

"Transgender people deserve access to transition-related surgery that is a medical necessity and recognized as such by every major medical organization," Nelson said.

Thomas said in a statement that "a weight was lifted" when he began his gender transition, but he rebuked the state's ban on reassignment surgery.

"Being denied surgical treatment is harmful to my health and well-being every day I'm forced to live in this body," Thomas said.

OutFront and Thomas seek a court declaration that excluding coverage for medically necessary transition-related surgery violates their rights. They are represented by Kristina Carlson of Dorsey & Whitney LLP in Minneapolis.

The mission of OutFront is to make Minnesota a place where LGBTQ people are free to be who they are and can live without fear of discrimination, according to Thursday's complaint. The group says it has between 1,500 and 2,000 members throughout Minnesota.

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