D.H. and John Doe are transgender teenagers who require male chest reconstruction surgery to treat their gender dysphoria. Arizona is refusing to cover this medically necessary treatment because of a categorical exclusion on covering surgical treatments for gender dysphoria in the state’s Medicaid regulations. That discriminatory exclusion violates well-established standards of care and federal law.

On August 6, 2020, the National Center for Lesbian Rights (NCLR) and the National Health Law Program (NHeLP), along with co-counsel King & Spalding LLP and Perkins Coie LLP, filed a class-action lawsuit challenging Arizona Medicaid’s categorical exclusion for surgical treatment for gender dysphoria. The complaint alleges that the categorical exclusion violates the EPSDT and comparability requirements of the Medicaid Act, Section 1557 of the Affordable Care Act, and the Equal Protection Clause of the United States Constitution.

On March 30, 2021, the District Court denied D.H. and John Doe’s Motion for Preliminary Injunction. In part, the court ruled that discrimination against transgender people is not sex discrimination under the ACA or the Equal Protection Clause. D.H. and John Doe have appealed that ruling to the U.S. Court of Appeals for the Ninth Circuit. The parties are in the process of briefing the appeal.

In the meantime, the case is proceeding through discovery in the District Court.