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WASHINGTON, D.C., August 19, 2019 (LifeSiteNews) – A federal judge ruled Friday that Wisconsin cannot exclude so-called gender-reassignment treatments, including both surgery and hormones, from coverage under the Medicaid program, striking down a rule that’s been on the books for decades.

U.S. District Judge William Conley was hearing a case brought by four gender-confused Medicaid patients against a 1997 Department of Health Services administrative provision that excluded “transsexual surgery” from Medicaid. In a 38-page opinion, Conley ruled that excluding the treatments constitutes sex discrimination under the federal Affordable Care Act (Obamacare), the Capital Journal reports.

“There is now a consensus within the medical profession that gender dysphoria is a serious medical condition, which if left untreated or inadequately treated can cause adverse symptoms, such as anxiety, depression, serious mental distress, self-harm and suicidal ideation,” he wrote, adding that insurance companies currently managing state HMO Medicaid plans “acknowledge that gender-confirming hormone and surgical treatments for gender dysphoria can be medically necessary.”

Wisconsin’s Medicaid system has an estimated $9.7 billion budget and 1.2 million enrollees, approximately 5,000 of whom are believed to have some form of gender confusion. The state says covering surgery for all of them could cost taxpayers as much as $2.1 million, and contends that transgender surgery has no proven medical benefit.

A variety of scientific literature indicates that reinforcing a patient’s gender confusion rather than helping him or her to overcome it fails to prevent significant emotional harm up to and including attempted suicide, with or without surgery. There is also a growing movement of former transgenders who have “de-transitioned” back to their real sex after experiencing “sex change regret.”

Last year, Conley issued a temporary injunction barring the state from enforcing the rule against two of the plaintiffs. Wisconsin is one of nine states that excludes gender-transition treatment from Medicaid.

Conley’s latest ruling comes after the Wisconsin Group Insurance Board voted 5-4 last August to cover hormone therapy and sex-reassignment surgery deemed “medically necessary” for public-sector employees.