State Should Pay for Gender-Reassignment Surgeries, Says Pa. Governor Wolf

Governor Wolf came to the defense of a Delco transgender man after Medicaid ruled against him.

Pennsylvania Gov. Tom Wolf speaks with members of the media Wednesday, Oct. 7, 2015, at the state Capitol in Harrisburg, Pa. Gov. Tom Wolf's hopes of ending Pennsylvania's 99-day-old state budget impasse were dashed Wednesday when nine of his fellow Democrats joined all House Republicans to vote against his revised plan to raise billions in income and gas drilling taxes.

Pennsylvania Gov. Tom Wolf speaks with members of the media Wednesday, Oct. 7, 2015, at the state Capitol in Harrisburg, Pa.

Pennsylvania Governor Tom Wolf is speaking out against the very state that he runs after the state-run Medicaid program said it wouldn’t pay for a gender-reassignment procedure for a 30-year-old transgender man who has since filed suit over the denial of coverage.

“The Pa. Code precludes coverage through Medicaid for gender confirmation medical care and surgical procedures,” said a Wolf spokesperson in a statement. “Governor Wolf believes this is wrong. Pennsylvania should not discriminate against any individual based on sexual orientation and gender identity and expression. The governor hopes to have a robust conversation with the legislature, community and all other parties regarding this issue to move the commonwealth forward.”

The northern New Jersey native, who previously worked as a schoolteacher in Delaware County, filed the lawsuit anonymously as a John Doe against Department of Health and Human Services Secretary Theodore “Ted” Dallas, attacking the Pennsylvania laws that discriminate against the trans community.

Section 1141.59 of the Pennsylvania Code details medical procedures not covered by the state.

According to the lawsuit, the anonymous transgender plaintiff has been diagnosed with gender dysphoria, commonly referred to as GD. In a person with GD, there is a major difference between the person’s expressed gender and the gender that others would assign to the person, according to American Psychiatric Association, and that conflict causes distress. The GD diagnosis itself is not without controversy. The plaintiff’s attorney, Chestnut Hill’s Julie Chovanes, compares GD to the expression of being a man trapped in a woman’s body, or vice versa, but in an extreme and distressful way.

One treatment for gender dysphoria in a transgender male — and the very one ordered by the plaintiff’s doctor — is an abdominal hysterectomy. Another commonly recommended treatment for gender dysphoria is hormone therapy, also excluded by the Pennsylvania law referenced above.

Pennsylvania’s Medicaid program does pay for hysterectomies for women, so the trans man is arguing that by denying his claim, the state is violating his rights for equal protection under the law and his right to be free from sex and transgender discrimination.

“I hope that this case will grant relief to our client and thousands of other Medicaid-eligible Pennsylvanians who are among the state’s neediest people,” says Chovanes, herself a trans woman. “We need to change the law, but we need to take it one step at a time.”

Although Wolf is sympathetic, the road to changing that law might not be an easy task, especially in such a large state with so many “red” counties. Consider that New York, Massachusetts, Oregon, California, Vermont, Minnesota and Washington D.C. are the only places that allow such surgeries to be covered under Medicaid.

Chovanes, executive director of the Trans Resource Foundation, believes that there could be as many as 16,000 Medicaid-eligible trans people in the state. Through Chovanes, her client declined to speak about the case.

Follow @VictorFiorillo on Twitter.

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  • hacker13

    Let’s pay for all cosmetic surgeries then. Why can’t a flat chested gal get the C or D cups she needs to feel like a confident woman on the State’s dime?

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    • Andrew Kelley

      We’re talking about a hysterectomy, not chest reconstructive surgery. The ONLY reason it’s not being covered is because he’s trans. The article states that medicaid covers them, just not for transmen.

      • hacker13

        Do non-trans women have hysterectomies for the hell of it, or because it is medically necessary?

        • LOLOL

          That’s not a valid comparison. He’s not getting it “for the hell of it.” This person’s licensed doctor has advised that he get this surgery. Medicaid is denying payment only because he’s trans, and that’s wrong.

          • oldspeak

            No, it’s not. It’s still cosmetic. There’s no physical medical necessity for the surgery. What should happen is the patient should be referred for intensive therapy.

          • LOLOL

            The patient’s licensed physician has advised the surgery. You’re not the patient’s doctor, so your view on what should happen doesn’t actually matter.

          • hacker13

            The article doesn’t specify it was his licensed physician- it just says doctor which could also mean psychologist.

          • Megalus Doomslayer

            Psychologists don’t prescribe medicine or surgery. Psychiatrists do and they are the leading profession for dealing with transgender health matters.

          • Mark

            Yes it does if your going to use my money. I would have to pay a very large sum of money to do it on my own, but why should a person on Medicaid be able to get it at no cost.

          • Andrew Kelley

            I have no idea whether or not this state has expanded medicaid under the affordable care act but, if they have this is the option that this person would have instead of a private insurer.

          • Mark

            Again, are licensed physicians ever wrong. Of course not and I got that from the internet.

          • Philly is a toilet

            If you’re requesting to use public money for this purpose, then yes, our views matter

          • Megalus Doomslayer

            If the general public was consulted on medical matters, most patients would be dead. That’s why it takes an education to get a license. Your quackery comes from what medical institution exactly?

          • Andrew Kelley

            “The American Medical Association is calling on health insurers to cooperate with doctors in providing proper care to meet transgender patients’ needs.

            Resolutions 114, 115 and 122 were passed by the AMA’s House of Delegates at its annual conference in Chicago, which concludes today. Noting that Gender Identity Disorder is an internationally recognized medical condition, the Delegates highlight the need to combat the emotional pain and physical incongruity associated with gender dysphoria with proper access to mental health services, hormone treatments, and surgical procedures.”
            and from the American Psychiatric association.
            “APA Position:

            Therefore, the American Psychiatric Association:

            1. Recognizes that appropriately evaluated transgender

            and gender variant individuals can benefit greatly

            from medical and surgical gender transition treatments.

            2. Advocates for removal of barriers to care and

            supports both public and private health insurance

            coverage for gender transition treatment.

            3. Opposes categorical exclusions of coverage for such

            medically necessary treatment when prescribed by a

            physician.”

          • Mark

            Please read Dr. Paul McHugh’s writings. And then get back to me.

          • Andrew Kelley

            Yup, he’s a real winner. “Conservatives champion McHugh as an expert on transgender identities, but his antiquated rhetoric and biased rejection of what transgender people experience set him drastically apart from the consensus of psychiatrists and the standards of care that best support transgender people’s health.” Why don’t you just cite Pat Robertson while you’re at it.

          • Megalus Doomslayer

            Even Pat Robertson supports sex changes. These conservatives are fighting a losing battle.

          • Philly is a toilet

            There is still a large dmographic in the US that doesnt want the homosexual lifestyle promoted by the state. You are asking that the state promote that lifestyle, stop pretending that this is about a ‘medical’ treatment.

          • Philly is a toilet

            Once upon a time, they said that homosexuality was a mental disorder. The AMA is pushing a liberal agenda and we are finally pushing back

          • hacker13

            Its not medically necessary for him to function as a trans man, so why should Medicaid pay for it? A woman wouldn’t have a hysterectomy unless there was a danger to her health – is that the case here? Do you think Medicaid should cover breast augmentation as well for woman who feel they needed it to be more confident and successful?

          • Mark

            Is everything that a doctor prescribes correct. How about a second opinion from Dr. Paul McHugh.

          • Corpseman57

            You can find plenty of liberal doctors to sign phony baloney orders and ‘scripts.

          • Philly is a toilet

            No, it’s not wrong. It is ELECTIVE surgery. We shouldn’t have to pay for it

        • Andrew Kelley

          Um…trans WOMEN don’t have hysterectomies. TransMEN frequently get denied coverage from them even when they have life-threatening medical needs for them. The American medical Association does recognize this as as a medical treatment for a medical condition. “The American Medical Association is calling on health insurers to cooperate with doctors in providing proper care to meet transgender patients’ needs.

          Resolutions 114, 115 and 122 were passed by the AMA’s House of Delegates at its annual conference in Chicago, which concludes today. Noting that Gender Identity Disorder is an internationally recognized medical condition, the Delegates highlight the need to combat the emotional pain and physical incongruity associated with gender dysphoria with proper access to mental health services, hormone treatments, and surgical procedures.”

          • hacker13

            I never said trans women had hysterectomies. I said non trans women – i.e. genetic women.

            Second, I don’t disagree their is the notion of gender identity disorder. That being said, why should taxpayers have to fix God’s mistake? Trans folks always claim having certain body parts do not make him/her a male/female, then why is it medically necessary to correct their genitally? It certainly is a “nice have” and may give the person more confidence, but where do we draw the line between what is medically required/needed vs what is a not?

          • Andrew Kelley

            The AMA and the APA disagree with you. Many transmen DO need hysterectomies but frequently get them denied because they are transmen even when they have cancer, fibroids or endometriosis. It’s medical treatment that vastly improves the quality of life, lessons depression and the associated costs of treating that. A transpersons access to medical treatment greatly reduces the rate of suicide as well. The psychiatric community no longer considers transexuality to be a psychiatric order. It is classified as a medical disorder. The AMA considers gender reassignment surgery one of the medical treatments for it.

          • hacker13

            Plenty of women have depression because of the way they look and how they perceive society views them, whether they are overweight, flat chested, over endowed, etc. Should insurance start paying for their cosmetic surgeries to reduce depression and the associated costs?

          • Andrew Kelley

            It does pay for breast reduction when there’s a medical need.Insurance does pay for weight loss treatments including lapband surgery. . It often covers surgery for gynecomastia in males,but not transmales.It also pays in some cases for plastic surgery after extreme weight loss. And in answer to your question if an individual has a serious cosmetic issue, scars etc., yes I think they should pay for it.

      • Trouble

        If the patient needs a hysterectomy, the the patient is a SHE. MEN do not have uteri.

      • Teresa Ann Ramsey

        Whoa! Women do not get hysterectomies just cause they want to. There is a medically necessary reason. There are serious effects that come from the surgery. It’s not being covered because he doesn’t have the necessary organs for it. There fore it would be a voluntary reconstructive surgery.

        • Andrew Kelley

          I’m confused, what do you mean “he doesn’t have the necessary organs for it”?

  • SoSorry

    Good grief, state paying for body modification?????

    • LOLOL

      Nope, he’s calling for the state to pay for surgery recommended on the advice of a licensed physician, which is being denied only because of the patient’s gender assigned at birth.

      • SoSorry

        And he is asking for a hysterectomy why? What is the MEDICAL reason he NEEDS one? Is his life in danger without the surgery?

        • LOLOL

          The medical reason is that a licensed physician has advised that he get the surgery. Medicaid does not require one’s life to be in danger to pay for surgery.

          • oldspeak

            In other words, no medical reason. A mental one.

          • LOLOL

            Since the patient’s licensed physician has advised the surgery, then there is a medical reason for it. Throwing around “mental” like it’s an insult is pretty annoying and doesn’t change that it’s wrong for Medicaid to deny payment here.

          • Trouble

            I’m glad to know free health care is so much more easygoing than paid for plans.

          • Corpseman57

            Let’s look in the “licensed physican’s” closet to find out why he thinks the taxpayers should pay this bill.

        • Andrew Kelley

          It IS the medical treatment for a medical condition according to the AMA.

      • Corpseman57

        Licensed physician? Pfffft. Many are liberals with white coats shoving their fists into the taxpayer pockets to promote an agenda.

        • Megalus Doomslayer

          I know! Trying to provide medical care should be criminal! When our dear god Trump takes over, he’ll be sure to cancel everyone’s healthcare and imprison all doctors so we can be safe from the intrusion of medical treatment into our busy work schedules at the sweetshop.

  • FedUp

    Maybe Wolfe should give up his cancer treatments to pay for this poor confused soul.

    • Randi Wileman

      trans individuals are not confused

    • LOLOL

      He’s not “confused.” He’s in a situation that can be addressed with surgery, and the state is unfairly denying him coverage for the surgery.

      • SoSorry

        Again, WHY does he need this surgery? Is his life on the line without it?

        • LOLOL

          Whether a person’s “life is on the line without it” is not a requirement for Medicaid to pay for surgery.

          • Philly is a toilet

            It does when the money is coming out of my pocket.

        • Andrew Kelley

          Frequently, the persons life is online. Certainly their health do to years of living with severe depression and all too often from others who may discover their trans status. The rates of suicide attempt for nontrans individuals is about 4.6% compared to about 41%. The rate consistently drops when the individual has supportive family and also when they have access to appropriate medical treatment.

          • Philly is a toilet

            Why don’t you tell everyone how the suicide rate of transsexuals (who’ve had the operation) is also higher than the average American. Many transsexuals believe that their depression stems from some unmet need to be another gender, and then sink into depression. Then when they realize that receiving the operation did not diminish their depression, sink deeper into it.

      • Diablo4965

        He is not physically ill. Mentally but not physically!

        • LOLOL

          He’s under a doctor’s care, and that doctor has advised that he get surgery. That’s all Medicaid needs to know.

          • Corpseman57

            Did the doctor vote for obama?

          • Philly is a toilet

            It’s elective surgery, no different from breast augmentation surgery. And we should pay for neither

      • JudgeJudy

        Should medicaid pay for lap band surgery for being overweight? A person can argue they would have better self esteem, not to mention be healthier and be able to secure possible employment? If that’s the case, I’m applying. Im sorry but enough of this crap already!

        • Nickolas

          Medicaid DOES pay for lapband.

          • JudgeJudy

            That’s just crazy!! LOL

          • Andrew Kelley

            It’s much less expensive to treat someone with lapband surgery than to treat them for the complications of obesity.

          • Philly is a toilet

            They should pay for a gym membership out of their own pocket. $10 a month is not overly expensive. Let the LGBT community pay for it themselves

      • Philly is a toilet

        Then the LGBT community should set up a fund of their own to pay for it.

  • Choppers

    Medicare teeth whitening NOW!

    • LOLOL

      Nowhere near an accurate analogy.

      • Corpseman57

        Soon, it will be under uber liberal leadership.

  • jungle jim

    Guess i should be glad I moved from PA Hazleton is an illegal feces hole Allentown is riddled with crime… Landsford and Nesquehoning are ghost towns now cuz of Democratic lunacy !!! Yea great job Governor Great job !!!

    • Trouble

      I miss the Pennsy I grew up in, but am so glad to be gone now. It just saddens me to see what my state is becoming.

  • Colonel_Bob

    First the governor tells us he wants to raise taxes to close a structural deficit. Then he tells us he wants to spend more money on schools. Now he wants to expand Medicaid spending. The man speaks out both sides of his mouth.

  • Jayne Cobb

    What a sick POS.

    • LOLOL

      This is a hateful, transphobic comment that PhillyMag should delete immediately. The longer comments like this stay up, the less respect I have for this website.

      • oldspeak

        You can keep your fascist comments to yourself then, too.

        • LOLOL

          I’d like to hear your definition of “fascist.”

      • Trouble

        I don’t think phobic means what you think it means…

  • LOLOL

    MODERATE YOUR COMMENTS, Philadelphia Magazine. It is shameful to allow transphobic and gender-targeted abuse to be treated as normal discourse. Check the comments here or disallow them.

    • laszlomoholy

      QUICK! CENSOR FREE SPEECH! I HATE IT! It’s not SAFE FOR ME!

      You’re destroying this country.

      • LOLOL

        And you don’t understand the first thing about the First Amendment.

        • https://twitter.com/richcolton RichC

          Neither do you apparently. Las didn’t assert a Constitutional right to argue a point at the end of an online story, he just said “Free Speech.”

          It’s an American value. Or at least it used to be, until you people decided diversity, acceptance, and self-esteem were all more important.

          I could never vote for Trump – but comments like yours make me see why some people could.

          • Teresa Ann Ramsey

            You know what’s amusing about the Trump rise- they can’t see that they are part of the reason. It’s easier to just say that the GOP is imploding and it is granted, but they don’t understand their part in the anger.

      • Remrie Ra Arrie

        The freedom to be critical of others is not tantamount to having the freedom to insult, harass and bully another person and/or an entire demographic. The point of civil liberties is to promote and protect civility, not promote and protect the inhumane.

        • https://twitter.com/richcolton RichC

          No. Respectfully, you’re an idiot.

          The point of civil liberties is to protect liberty. You have no right to be protected from words that make you feel sad. The only speech that needs protection is unpopular speech.

          • Megalus Doomslayer

            This article is unpopular speech and therefore needs protection from spam.

  • Jordan Gwendolyn Davis

    First of all, this should be G Philly’s turf, as this is related to LGBT.

    Second, please delete these transphobic trolls

    Third, Governor Wolf has been supporting Trans surgery being covered by Medicaid since 2014. I know, I asked him.

  • Diablo4965

    This guys a f-ing moron!

    • LOLOL

      What a silly and childish thing to say.

  • PennsylvaniaSage

    Let Wolf pay for the surgery from his own personal wealth.

  • Nickolas

    Paying for medication and surgeries needed by Transgender people would be cheaper than the long run paying for the hospitalizations due to suicide attempts, depression, anxiety, disphoria etc. Also, when Transgender people are able to receive the care they NEED, they are more productive citizens.

    • Andrew Kelley

      What Nickolas said!

    • Corpseman57

      Get a job. Save your money. Pay for your own surgery.

      • Megalus Doomslayer

        Try getting a job that will pay for it. Can you afford over $100,000 in surgeries working at a dead-end job without the money necessary to pay off student loans which need to be taken out in order to get a bachelor’s degree for a job you can’t get because the job market is stagnant?

        • Teresa Ann Ramsey

          1. You should have made sure you could have a career in your chosen field before you sunk all the money into a piece of paper. Not our fault, it was your choice.
          2. You didn’t so now you are paying student loans for a piece of paper and are working a dead end job( like most people in this state). HMMMMM so you want the rest of the overtaxed, and cash strapped taxpayers to pay for your lack of prior planning. How sweet.

          • Megalus Doomslayer

            We’re told throughout our childhood that we have to get a degree. We can’t predict what job positions will be open when we finish our degree. It takes at least 4 years to get a bachelor’s degree. The job market can’t be predicted to a T like that. I can tell you didn’t get a college education. Your common sense is lacking.

  • Casey Evans

    Correction for your article: Washington State. Gender reassignment surgery is covered by the WA Health Care Authority. In addition to full coverage under Apple Health (Medicaid in Washington), it is also covered under the DOC for Washingtonian inmates, and by law, all private health care plans offered in the Evergreen State must include coverage for gender reassignment surgery. I’m also sure that my fellow Pacific Northwesterners that happen to be British Columbians would like it noted that their province covers it, as well.

    With BC, WA, and Oregon all in agreement, I believe there is now nowhere in the Pacific Northwest you cannot get gender reassignment surgery, abortion coverage, legal marijuana, marijuana stores, gay marriage, and “death with dignity”. From Victoria to Medford, our reputation as one the most left-wing places in the world is truly well deserved*.

    *In the Seattle area, we elect actual Socialists to office, and Socialist Alternative has grown to become the “second party”, relegating the GOP to fringe, third party status. I love the PNW. Now go correct your article, Philadelphia Magazine!

  • lalasayswhat

    I want a bigger pecker. It would make me more popular with the ladies, therefor boosting my self esteem. Pay me please.

    • Megalus Doomslayer

      Sorry, republicunts don’t like budgets that allocate money.

      • lalasayswhat

        I would think Bill clinton would be for peckers.

  • Ken Snyder

    Gee, wonder why Wolf’s approval is at 31%…..sounds a bit high…..

  • Louie

    Can’t you focus on the important stuff Mr Governor! We NEED a budget for 2015-2016 that supports agriculture in all forms. Oh and we NEED a budget that supports agriculture in all forms for 2016-2017 too, please!

  • Stephen J. Lubas

    I didn’t vote for this squirrely jackass. I never in my life saw someone open a barn on fire and have everybody run in. One term Tommy Thank God!

  • wazoo

    UFB ! The state Shouldn’t be asked to meet this burden.

  • Corpseman57

    I’d help pay for a brain transplant for Wolf. The man can’t find enough ways to spend MY money.

  • Corpseman57

    Let liberals pay for their loony causes. Set up gofundme type programs.

  • Corpseman57

    I’m sick of paying for things like this. GET A JOB AND PAY FOR YOUR OWN SURGERIES.

    • Megalus Doomslayer

      Are you in favor of raising the minimum wage to $100 an hour to pay for expensive medical treatments? I’m sure cancer patients would LOVE to be able to afford the massive medical bills they receive.

  • mike t

    If we want to win the war against ISIS without firing a single bullet or dropping any bombs, all we need to do is send this story to them and they will laugh themselves to death.

  • Jay Silla

    What’s next, plastic surgery for people who are unhappy with the shape of their nose, or the size of their boobs? Maybe Wolf will demand that the state buy everyone a new car, so the poor don’t have to feel embarrassed when they drive their old clunker, or ride the bus…

  • Robert C Glass

    Wolf should get his reassignment first.

  • TheHumanExtinction
  • Philly is a toilet

    This is a joke. State and municipal employees are working with a pension plan that is extremely underfunded and this moron want the state to pay for gender change operations? He’s filthy rich, let him pay for it out of his own pocket.

  • Linda Lander

    Why is he even on state insurance if he is a school teacher?

  • Concerned Parent

    I don’t dispute the hardships associated with being in a transgender situation. However, realistically, this is a small percentage of the population. How about Governor Wolf focusing his energy on getting a budget passed–as that issue is impacting a whole lot of vulnerable Pennsylvanians, before starting another fight? Seriously.

    • Megalus Doomslayer

      Most of the budget was passed a while ago. He’s just supporting someone in a legal battle. He can’t put the case on hold until it fits his schedule. Only a judge can move around dates.

  • Megalus Doomslayer

    Doctors are always warning of the dangers of cancer developing in unused organs. Why not just cite cancer risks as the main reason for the hysterectomy? If there’s an increased risk of cancer, then it would be negligence not to have it removed.