1. United States
2. Mich.
3. Letter

I need you to oppose any legislation that would ban or restrict gender-affirming care for transgender adults, and to support full Medicaid coverage for medically necessary transition-related care. The Fourth Circuit just ruled that West Virginia can exclude gender-affirming surgery from Medicaid, declaring it constitutional for states to "encourage citizens to appreciate their sex" by denying care. This is the first federal appeals court to extend the Supreme Court's Skrmetti decision on youth care bans to adults. The court called adult transgender care "dangerous" and "arguably ineffective" despite a 40-year follow-up study showing high patient satisfaction, improved outcomes, and zero patient regret. You can read more here: https://www.erininthemorning.com/p/4th-circuit-rules-that-states-can The ruling's logic is dangerous. The court claims no discrimination exists because the ban applies equally to transgender and cisgender people seeking care for gender dysphoria. But cisgender people don't seek that care, making the equality purely theoretical. This is the same reasoning Virginia used to defend its ban on interracial marriage in Loving v. Virginia, arguing it applied equally to Black and white citizens. The Supreme Court rejected that argument in 1967. If states can constitutionally "encourage citizens to appreciate their sex," nothing stops them from banning gender markers on IDs, criminalizing cross-gender clothing, or mandating conversion therapy. Heritage Foundation president Kevin Roberts already announced adult care bans are their next target, calling for states to "outlaw it" entirely. Transgender adults deserve access to evidence-based medical care. These bans trample on trans rights. Stand against them.