“In short, other than certain races, one would be
hard-pressed to identify a class of people more discriminated against historically … than transgender people.”

U.S. District Court Judge for the Western District of Wisconsin William M. Conley

American Family Association often tries to delegitimize Southern Poverty Law Center. They do not like the fact that they are deemed a hate group. Rather than attacking SPLC they should stop doing the things that caused them to be deemed a hate group  in the first place. Trying to marginalize sexual minorities is hate by any meaningful definition.

Today’s polemic titled Judge: Trans surgery ‘medically necessary’ – and Medicaid covers the bill is intended to outrage supporters of the hate group:

A federal judge has ruled that Wisconsin has to pay for body mutilation surgery on two transgender individuals.

The correct name for the procedure is “gender affirming surgery.” The fact that the fine physicians at AFA disapprove of transgender people does not alter medical science. Walker Wildmon and Tim Wildmon went to med school, right?

There is also the idea that transgender people are stupid or ignorant. They are supposedly doing something that is harmful to them. That is not the case. Trans folks know more about the procedure, its benefits and risks than anyone at AFA.

Judge William Conley wrote the following as undisputed fact:

Gender dysphoria is a serious medical condition, which if left untreated or inadequately
treated can cause adverse symptoms. The DSM-5 contains the psychiatric consensus as to the
definition, diagnostic criteria and features for gender dysphoria.

Gender dysphoria refers to the distress that may accompany the
incongruence between one’s experienced or expressed gender and
one’s assigned gender. Although not all individuals will
experience distress as a result of such incongruence, many are
distressed if the desired physical interventions by means of
hormones and/or surgery are not available. The current term is
more descriptive than the previous DSM-IV term gender identity
disorder and focuses on dysphoria as the clinical problem, not
identity per se.

In his opinion, Judge Conley writes (emphasis added):

As noted, plaintiffs are being denied coverage for medically necessary treatment that
was prescribed by their doctors and meets the prevailing standards of care. They contend that
allowing them to obtain their surgeries is necessary to protect their well-being and health
because they “are at high risk of worsening mental health, exacerbated gender dysphoria, selfharm
and stigma” …

Lawrence Mayer was an expert witness for the defense. Mayer, you will recall, was the co-author (with Paul McHugh) of an anti-LGBT treatise in the New Atlantis which does not submit articles to peer review. Despite his bias towards a psychological intervention, he was intellectually honest:

Even Dr. Mayer acknowledges, however, that gender dysphoria “is a serious medical
condition that deserves to be treated” and that such treatment “must be borne of medical
necessity.” (Id. at 8.) He agrees that “reducing or eliminating” the very real distress associated
with this condition is the “[o]ptimality consideration[]” for treating gender dysphoria.

In other words the first and most important consideration is alleviating the distress caused by the condition. Later on the judge writes about the disparity in health care:

In short, other than certain races, one would be
hard-pressed to identify a class of people more discriminated against historically or otherwise
more deserving of the application of heightened scrutiny when singled out for adverse treatment, than transgender people.

Getting back to AFA’s screed:

Julaine Appling of Wisconsin Family Action says activists are at work here.

“It’s not biological, it’s ideological – and I believe this is a test case to try to get it to the Supreme Court to get a decision that says … these folks are in a position where they have to have these kinds of surgeries, and yet taxpayers have to pay for it,” she laments.

I have read the opinion in full. It reflects a very well-argued case by astute lawyers for the plaintiffs. The lead attorney was Abigail Koelzer Coursolle out of Los Angeles. She is with the National Health Law Program. She attended both UCLA and Yale law schools.

As for these Christian groups, when things break their way, thank God. When things don’t go their way, blame mythical activists. Later on:

Appling says the science is less than convincing that having “gender-reassignment surgery” is the best treatment for someone with the mental disorder.

Where did this awful woman go to medical school? Oh, she did not. What a shock.

Appling sees a slippery slope ahead, especially when it involves children.

“… You can be sure with the approach that’s going on here that eventually there will be kids who will be low income – and we as taxpayers will again be complicit in paying for a surgery that is going to forever mutilate their bodies,” she tells OneNewsNow.

I hope that gender dysphoric kids are getting all of the medical care that is medically necessary regardless of family finances. Puberty blockers followed by hormones and then, possibly, surgery produces the best outcome.

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By David Cary Hart

Retired CEO. Formerly a W.E. Deming-trained quality-management consultant. Now just a cranky Jewish queer. Gay cis. He/Him/His.