Wednesday, July 13, 2022

Yale researchers condemn Florida's misleading and flawed report used to deny gender-affirming care to Medicaid users


Due to the political desires of its governor, Ron DeSantis, Florida has been raging against the transgender community. It's latest goal is to deny gender affirming care for Medicaid users. On Friday of last week, a biased hearing was held on the matter 

According to the Sun Sentinel:

Friday’s meeting drew more than 150 people, with supporters of the proposed rule — many of them sporting “Let Kids Be Kids” decals and making biblical references — vastly outnumbering opponents. Speakers supporting the proposal included a Baptist minister, members of the Florida Citizens Alliance, the head of the Christian Family Coalition, the founder of the Florida Prayer Network, a representative of the Florida Federation of Republican Women and a man carrying a giant American flag on a pole.

It's the same as the marriage equality fight. If you will remember, opponents of marriage equality were very successful in rallying supporters and seizing headlines. But this success always withered away when facts by noted experts were brought in. Apparently this fight is no different.

Today, a group of researchers from Yale University announced their review of Florida's justification to deny gender affirming care to Medicaid users. And it was not pretty. 

As Florida policymakers pursue state-level restrictions on transgender care, legal and medical experts from Yale Law School, the Yale School of Medicine’s Child Study Center and Departments of Psychiatry and Pediatrics, University of Texas Southwestern, and University of Alabama at Birmingham have released a new report that identifies and refutes the many unscientific claims behind the effort. The Florida Agency for Health Care Administration’s (AHCA) June 2 Report alleges that nationally accepted standard medical care for gender dysphoria does not meet generally accepted medical standards for Medicaid coverage. A team of seven scientists and a law professor argue the State of Florida’s position is “thoroughly flawed and lacking scientific weight.” 

 The report, “A Critical Review of the June 2022 Florida Medicaid Report on the Medical Treatment of Gender Dysphoria,” represents the first comprehensive examination of Florida’s June 2 Report, which the authors contend is a misleading document intended to justify denying Florida Medicaid coverage for gender dysphoria treatment. Nothing in Florida’s June 2 Report calls into question the scientific foundations of standard medical care for gender dysphoria, according to the authors.

According to the Yale Law School press release, the researchers listed in the report and in a July 2 public letter four ways in which The Florida Agency for Health Care Administration’s (AHCA)'s report was inaccurate:

The Florida report falsely claims that the scientific evidence does not support medical treatment for gender dysphoria. In fact, medical care for gender dysphoria is supported by a robust scientific consensus. Medical care for gender dysphoria (sometimes called “gender-affirming care”) has been used worldwide for decades, meets generally accepted medical standards, and is not experimental. The Florida report urges a discriminatory policy that violates the federal and state constitutions and federal and state law. 

The Florida AHCA offered the report to justify the denial of Medicaid coverage for medical care for gender dysphoria. But this discriminatory policy illegally targets transgender people. Neither the June 2 report nor the AHCA proposal would apply to similar treatments routinely offered to cisgender people. 

The Florida report repeatedly and erroneously dismisses solid medical research studies as “low quality,” demonstrating a faulty understanding of statistics, medical regulation, and scientific research. The report makes unfounded criticisms of robust and well-regarded clinical research, while disregarding others. If Florida’s Medicaid program applied the June 2 Report’s approach to all medical procedures equally, it would have to deny coverage for widely used medications like statins (cholesterol-lowering drugs taken by millions of older Americans) and common medical procedures like mammograms and routine surgeries. 

The Florida report cites sources that have no scientific merit. The report relies on pseudo-science, particularly purported expert reports that are biased and full of errors. The claimed reports are written by authors whose testimony has been disqualified in court and who have known ties to anti-LGBTQ advocacy groups. The report’s unfounded claims come from unqualified sources, which include a blog entry, letters to the editor, and opinion pieces.

There are two important things to remember about this. 

First, what's happening in Florida is the latest incident in which conservatives have distorted research and incidents in order to excuse anti-trans laws and other government actions. In March of this year, TX attorney general Ken Paxton issued an opinion that affirming care for trans youth was 'child abuse.' But the justification of his opinion was called misleading by several researchers, including one whose work he cited.

In November of last year, a USA Today article pointed out how conservative and right-wing groups were relying on bad evidence to pass bills keeping trans women and girls from competing in sports. Their "evidence" included claiming that a cisgender girl was transgender simply because she had a short haircut and claiming that cisgender female athletes in general were having scholarships stolen from them without providing any proof that this was taking place.

Secondly,  the Yale report underscores how a reliance on bad researchers and distorted science is an old modus operandi by those seeking to undermine LGBTQ rights. The same tactics used against the trans community today was used against gays just a few years ago.

On a fairly high number of instances, this blog has pointed out how religious right groups like the Family Research Counsel, the American Family Association, and various affiliates have either cited junk science or cherry-picked legitimate science to denigrate us with the false claims such as

1. Gay men molest children at a high rate

2. Being gay shortens your lifespan

3. Lesbian relationships are violent

4. Children should not be raised in LGBTQ homes

Not to mention other ridiculous claims such as we eat feces and stuff gerbils up our rectums.

Several times, they repeated these distortions even after they were refuted. It was a building block for their defense of the Defense of Marriage Act (DOMA). Their unsuccessful defense, I might add. During that same time, these folks pushed an anti-gay parenting study so flawed that it was practically laughed out of court.

This is the problem which no one seems to be pinpointing. The religious right, conservatives, and their allies are using the same tactics to denigrate transgender Americans which they used when they were smearing gays. The only thing which has changed are their targets. As gays become more accepted and our lives become less of a mystery, they can't exploit the fear about us as much as they have in the past. Granted, we still face a lot of bigotry and prejudice, but it's safe to say that a lion's share of it these days is directed towards the transgender community.  Gays are no longer useful scapegoats of conservatives and the religious right, so they have moved to the transgender community.

It's all about the fear of the unknown and exploiting it to put our community on the defensive. That stops when we begin calling them out for their lies, which we should do loudly and often. The Yale researchers have lighted the path and we shouldn't ignore it.

Related posts:

Four times the Family Research Council falsely connected homosexuality and pedophilia 







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