North Carolina Medicaid expansion would increase funds for child sex changes

Medicaid expansion is currently a top priority for lawmakers in North Carolina, but some are concerned that this expansion will increase the number of children in the state undergoing experimental sex changes.

The proposed increase in coverage is supported by both Democrats and Republicans, who say that it will help families access essential treatment for conditions such as diabetes, cancer and mental health issues. But Medicaid also covers what are deemed to be medically necessary sex change procedures for minors.

According to parental rights group Education First, one of North Carolina’s main Medicaid providers, Centene, covers a range of experimental sex change interventions for minors, including puberty blockers and cross-sex hormones, hysterectomies and double mastectomies, as well as complicated and risky genital surgeries such as vaginoplasty (the amputation of the penis and construction of a cavity to resemble a vagina), and phalloplasty (involving stripping skin and flesh from the forearm or thigh and using it to create a non-functional appendage resembling a penis).

Centene’s policy requires that a child have a clinical diagnosis of gender dysphoria prior to receiving treatment and must have lived in their acquired gender for 12 continuous months in order to be eligible for coverage. Living as your preferred gender can be as simple as adopting new pronouns.

Centene defines gender identity as “a person’s deepest inner sense of being female or male, which for many is established by the age of 2 - 3 years.”

Education First states that pediatric gender clinics in North Carolina, such as those located at University of North Carolina (UNC) and East Carolina University (ECU), treat children as young as four years old for gender dysphoria.

ECU also offers Safe Zone training to school staff covering topics of gender and sexuality and focusing on the importance of pronouns and affirmation of gender identities. 

According to the NC Department of Health and Human Services, one in four residents receive Medicaid benefits, but North Carolina is one of nine states that does not address the issue of child sex changes in state statute or policy.

The Youth Protection Act that was proposed in 2021 would have banned doctors from performing experimental sex changes on children and would have increased the minimum age for sex change surgeries to 21.

The reimbursement rate for Medicaid services is currently 74%, but could go up to 80% - 90% if the proposed expansion is passed.

However, costly as the procedures are, most opposition to child sex changes are not due to cost. Those opposed to children being a part of this medical experiment argue that there is no evidence to support medically transitioning children, and mounting evidence to show that the risks far outweigh the benefits.

Sweden and Finland have both conducted systematic reviews of the evidence for puberty suppression and cross-sex hormones and found the evidence to be of such poor quality that both nations now treat gender distressed youth with psychotherapy and only offer puberty blockers in the strictest of clinical trial settings. England is expected to take the same step in the coming months on completion of the independent review of its youth gender services.

Even prominent gender-affirming care proponents have recently acknowledged the social contagion element that is driving young people to identify as transgender. Dr. Marci Bowers, president of the World Professional Association for Transgender Health (WPATH) said in a recent interview that to deny that social contagion is a factor is “just not recognizing human behavior.”