Democratic Minnesota Gov. Tim Walz’ administration opened the door to state-funded sex genital surgeries for minors last year when it removed age restrictions on most transgender procedures from the state’s healthcare policy.

Walz, who is now presumptive Democratic presidential nominee Kamala Harris’ running mate, instructed Minnesota’s Department of Human Services (DHS) to ensure “up-to-date, medically necessary gender affirming treatments are covered” for reimbursement by the state’s health care program in a March 2023 executive order. Later that month, the Health Services Advisory Council (HSAC), a 14-member council appointed by the DHS commissioner, took up the issue of reforming the policy over the course of five meetings beginning in March, according to meeting minutes and other public records.

The HSAC ultimately voted not to add age criteria for breast removal and recommended following “WPATH standards” for a range of other procedures. Based on the council’s recommendations, the DHS updated the coverage policy in September 2023 to “remove most age restrictions,” except for a requirement to be over 18 for phalloplasty.

HSAC members are paid $200 per meeting, according to the DHS website.

Previously, Minnesota Health Care Programs (MHCP) policy required members to be over 18 to receive coverage for any genital surgery, according to an April 2023 meeting agenda.

WPATH Standards of Care Version 8 (SoC 8) guidelines released in September 2022, which HSAC considered when making its recommendations, also removed age limits for procedures like cross-sex hormones and surgeries. WPATH allowed its updated guidelines to be influenced by pressure to advance litigation and policy goals, including pressure from the Biden administration, court documents unsealed in June revealed.

Assistant Secretary for Health Rachel Levine pressured WPATH to remove minimum age recommendations, according to court documents.

Before making their decision, the HSAC heard presentations from multiple transgender activists, including co-chair of WPATH SOC-8 Eli Coleman and Children’s Minnesota Gender Health Program medical director Dr. Angela Kade Goepferd.

In a document SOC-8 leadership created to defend their recommendations, Coleman identified “academics and scientists who are naturally skeptical” and “continuing pressure in health care to provide evidence-based care” as sources of the “attack” on trans healthcare, according to court documents from a case challenging Alabama’s ban on sex change procedures for children.

Goepferd’s clinic offers children over 10 years old an opportunity to “meet individually” to discuss their gender identity and “possible treatment options” through its Gender Health Program, according to the clinic’s website.

Goepferd testified in favor of Minnesota’s “Trans Refuge” bill passed last year. In 2020, Goepferd gave a TEDx talk in 2020 titled, “The revolutionary truth about kids and gender identity.”

Since MHCP coverage for transgender procedures began in 2017, the state has provided reimbursements for a total of 1,609 procedures for patients of unspecified ages, including 632 mastectomies and 559 genital surgeries, according to a March 2023 presentation.

Walz’s All-Of-Government Push

While the HSAC was looking into insurance policy changes, Walz signed the legislature’s “Trans Refuge” bill into law. The bill, which protects children who travel to Minnesota for transgender procedures from the law in other states, also gives state courts “temporary emergency jurisdiction” when a child has been “unable to obtain gender-affirming health care.”

Walz’ sought to set Minnesota up as an example as other states were restricting sex change surgeries for minors.

“In Minnesota, we value LGBTQIA+ community members, we safeguard their rights,” he wrote in the March executive order. “We are committed to protecting access to gender affirming health care services.”

In a November 2023 memo to insurance companies and medical centers, the Minnesota Department of Health also warned that it would use “its powers, authorities, and duties to the fullest extent possible to take all appropriate actions to protect Minnesotans’ access to gender affirming health care services.” (RELATED: Harris ‘Loved’ Walz’s Record Despite ‘Abject Failure’ On 2020 Riots, Stringent Covid Policies And More)

“Importantly, MDHR will investigate charges, file complaints or civil actions, and/or seek injunctive relief when MDHR receives a charge of discrimination or has reason to believe that discrimination is occurring on the basis of a person’s sex and/or gender identity,” the memo stated.

Minnesota’s DHS and the Harris campaign did not immediately respond to requests for comment.

AUTHORS

Katelynn Richardson and Megan Brock

Contributors.

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