Judge denies request for ‘mental exams’ of 12-year-olds in Medicaid transgender lawsuit

A federal judge has rejected a request by Gov. Ron DeSantis’ administration to conduct “mental examinations” on a pair of 12-year-olds who are plaintiffs in a challenge to a state rule prohibiting Medicaid coverage for gender-affirming care for transgender people.

U.S. District Judge Robert Hinkle’s two-page decision, released Wednesday, came after lawyers for the Florida Agency for Health Care Administration, which largely oversees the Medicaid program, filed a motion asking him to order evaluations of plaintiffs identified as “Susan Doe” and “K.F.”

Geeta Nangia, a South Carolina-based psychiatrist selected by the state to conduct the exams, in court documents challenged the use of medical interventions for trans children and adolescents, calling such treatment “risky at best” and supporting the state’s stance.

Hinkle’s decision noted that the state’s motion identified Nangia’s qualifications as a psychiatrist who treats children and adolescents, but he said it “does not address her experience treating transgender” youths.

“Her expert report — not mentioned in the motion — says she has treated over a thousand patients with gender dysphoria. But the report does not indicate how many of those patients, if any, she supported in their identified gender,” Hinkle’s decision said.

The judge also pointed to a Nov. 15 scheduling order in which he said that, under court rules, the plaintiffs could have to undergo “appropriate examinations … but no individual will be required to submit to an examination by a transgender denier or skeptic.”

“Because the current motion does not address whether Dr. Nangia is a transgender denier or skeptic, this order denies the motion,” Hinkle wrote. “Any renewed motion should address how many patients Dr. Nangia has supported in their identified gender. Any renewed motion should also address how any finding from an examination might affect a ruling on the controlling substantive issue of whether treatments at issue are experimental.”

Four transgender plaintiffs, including Susan Doe and K.F., filed a federal lawsuit challenging the rule, alleging treatment of gender dysphoria is “medically necessary, safe and effective” for transgender children and adults.

In the lawsuit, parents of the children diagnosed with gender dysphoria expressed concern that the changes to the Medicaid program would have a negative effect on their children’s mental health and could even lead to attempted suicide. The federal government defines gender dysphoria as clinically “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”

But in a motion filed Tuesday, the state’s lawyers argued Nangia needed to examine the children.

“Defendants are entitled to confirm whether or not plaintiffs suffer from gender dysphoria. Defendants also are entitled to explore whether plaintiffs have undergone appropriate mental health treatment. And defendants are entitled to explore whether comorbidities, such as depression and anxiety, may be the root cause of plaintiffs’ emotional distress, and whether reversal of their gender affirming treatment will negatively impact their mental health as alleged,” Mohammad Jazil, the state’s lead lawyer on the case, argued.