Official photo of Commissioner Emily Johnson Piper (Photo: Minnesota Department of Human Services).
The American Civil Liberties Union (ACLU) and the ACLU of Minnesota filed a lawsuit on Thursday in Minnesota State Court challenging the current ban on using covering transition-related surgery expenses for transgender people.
The ACLU, which filed the lawsuit on behalf of Evan Thomas and the LGBT rights group OutFront Minnesota, is suing Emily Johnson Piper in her role as the Commissioner of Minnesota’s Department of Human Services, and demanding that the state repeal the coverage exclusions in both Medical Assistance, the state’s Medicaid program, and MinnesotaCare, the state’s program for lower-income residents without access to employee-sponsored health insurance. The ACLU argues that not only is the current exclusions are both discriminatory against transgender people, and have no basis in medical science.
“For many transgender people, transition-related surgery is a medical necessity and can sometimes be a matter of life and death,” Joshua Block, an attorney with the ACLU’s Lesbian, Gay, Bisexual, and Transgender Project. “Transgender Minnesotans — like everyone else — should be able to receive adequate health care based on medical standards of care.”
Under current Minnesota law, all transition-related surgical care is denied coverage, regardless of whether it is medically necessary for treating a person’s gender dysphoria. However, the same treatments are required to be covered under the federal Medicare program and under all private health insurance plans regulated by the state of Minnesota.
“Every major medical organization has recognized that policies banning coverage for medically necessary transition care have no basis in modern medical science,” Block continued. “Minnesota’s statute is a historical relic based purely on disapproval of transgender people.”
In addition to Medicare, 10 other states and the District of Columbia currently provide coverage for transition-related surgical care through their public health insurance or Medicaid programs.
Thomas, the lead plaintiff in the case, is currently on Medical Assistance and has been diagnosed with gender dysphoria. After fighting depression, Thomas was able to begin hormone therapy and legally changed his name and gender earlier this year. But he is still being denied coverage for medically necessary transition-related surgery.
“A weight was lifted when I first began my gender transition and realized I didn’t have to pretend to be a woman anymore,” Thomas said in a statement. “Being denied surgical treatment is harmful to my health and well-being every day I’m forced to live in this body.”
President Donald Trump used his address to Congress on Tuesday, March 4, to attack transgender individuals, calling transgender identity a "lie" and railing against transgender athletes, gender-affirming care, and trans visibility in the military and more broadly within society.
At one point during the speech, Trump switched from speaking about a child who was diagnosed with cancer to claim his administration was protecting children from "toxic ideologies" in schools.
He brought up the story of January Littlejohn, a Florida anti-transgender activist who sued the Leon County School District in Tallahassee, Flordia, in 2021, alleging that her child's school had discussed restrooms and name change requests with the child, assisting her in "socially transitioning" without informing Littlejohn or her husband of their efforts.
The Trump administration suspended $175 million in federal funding for the University of Pennsylvania as punishment for having allowed transgender swimmer Lia Thomas to compete in 2022.
Thomas originally competed for the men's swim team but competed on the women's team following her transition.
She complied with what NCAA regulations regarding transgender athlete eligibility were at the time, undergoing hormone therapy for a year before competing.
In 2022, Thomas began breaking school and meet records, becoming the first transgender woman to win an NCAA swimming championship medal in the Division I women's 500-yard freestyle event.
A newly introduced Republican bill in Texas seeks to criminalize anyone who identifies as transgender.
Introduced by State Rep. Tom Oliverson (R-Cypress), the bill would amend the Texas Penal Code to create a new form of fraud known as "gender identity fraud."
Under the bill, if a person makes a "false or misleading verbal or written statement" to a government entity or a private employer asserting that their gender is the opposite of the biological sex assigned to the person at birth, that person could be charged with a felony, could serve up to two years in prison, and be fined $10,000.
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