Texas quietly restricts gender-affirming care for trans adults: 'Canary in the coalmine'

Starting tomorrow, Texas Medicaid will no longer cover gender affirming care for transgender adults in the state.

The new rule will go into effect as of Friday, March 1 through Texas Health and Human Services. It prohibits Medicaid from covering the cost of “Hormone Therapy Agents” for anyone who has been diagnosed with gender dysphoria within the past 730 days.

The rule was condemned by a coalition of LGBTQ+ rights groups, who noted that "this decision appears to have been implemented with no public hearing and no opportunity for public input, which is usually required." Ricardo Martinez, CEO of Equality Texas, recalled that the policy was even "voted down at the last public Drug Utilization Review Board meeting."

Emmett Schelling, executive director of Transgender Education Network of Texas (TENT), said in a statement that it "is the canary in the coalmine for their end goal - a full ban on our access to health care and terminating our ability for us to exist in the public square."

"Cruelty is the point. Cruelty has always been the point," he said. "No matter what they do, the facts don’t change. We have always existed, all people deserve access to health care. That is simple humanity. People’s lives should never be 'up for debate.' Trans Texans will continue to live in our truth in the place we call home. We’re organizing just as our trans and queer elders before us, and we’re not scared.

The coalition — which consists of TENT, Texas Freedom Network (TFN), the Human Rights Campaign (HRC), Equality Texas, and the ACLU of Texas — assured that "most trans Texans will not be impacted by this rule change" as "health care for trans adults in Texas remains legal." Still, leadership warned of what it signals for gender-affirming care and health care broadly.

“Make no mistake, Texas’ ongoing attack on life-saving, medically necessary care is not, nor has it ever been, about the protection and well-being of children," HRC Texas State Director Melodía Gutiérrez said. "MAGA politicians and bureaucrats have made clear their intent: they don’t believe that transgender people of any age should be able to get best practice healthcare, simply because they are transgender. Every Texan should be frightened now that the boundaries to government intrusion into one’s health care are even less certain."