A Pennsylvania state lawmaker is holding transgender kids hostage as a condition of extending the Children’s Health Insurance Program (CHIP).

Last week, state Sen. Donald White (R) attached an amendment to the CHIP renewal legislation that would prohibit the program from covering the costs of any services related to a gender transition. The language of the amendment is vague enough that it could impact a broad swath of services that are medically necessary for the well-being of a transgender child:

The benefit package for eligible children may not include reimbursement for gender or sex reassignment surgery or gender or sex transition services, including, but not limited to, physician’s services, inpatient and outpatient hospital services, prescribed drugs or counseling services related to such surgery or services.

White seemed to indicate that his amendment was meant to address surgeries. “It is completely inappropriate to use state funds to pay for sex change operations for children,” he said in a statement. “This program provides vital health care services for Pennsylvania’s children. It is irresponsible to allow its limited resources to be used for sex change procedures.”

But because the language refers to surgery “or gender or sex transition services,” it’s unclear if it could also refer to doctors who recommend social transition for younger children, or the prescription of puberty blockers or cross-sex hormones. Essentially, it could cut off health care coverage entirely for transgender kids if no doctor they see is allowed to affirm their gender identity.


White’s statement is also a bit of a misnomer. Generally, “children” do not undergo gender confirmation surgeries. The World Professional Association for Transgender Health (WPATH) recommends in its standards of care that young people should only undergo surgery after they’ve reached the age of medical consent, which in Pennsylvania is 18. But CHIP provides coverage up until an individual’s 19th birthday, which means that even if the amendment narrowly applied to surgeries, it could still very well prevent some transgender young people from accessing the medically necessary care they need and deserve.

The claim that transition-related medical costs are too expensive was similarly used to justify banning transgender people from serving in the military. Congresswoman Vicky Hartzler (R-MO) seemingly invented bogus numbers out of thin air to justify her legislative ban, and the Family Research Council, an anti-LGBTQ hate group, followed suit with a “study” offering numbers even less connected to reality. President Trump then said that cost was a factor in his decision to institute the ban unilaterally. Besides the fact that transition-related coverage is a drop in the bucket of medical spending, these arguments completely erase the fact that this care is medically necessary to help transgender people resolve their gender dysphoria and live happy and healthy lives.

Pennsylvania’s CHIP program provides health care coverage for some 174,000 young people across the state. As Freedom for All Americans notes, Pennsylvania is one of 32 states that offers no explicit nondiscrimination protections for LGBTQ people under state law.

White’s amendment passed the Senate Banking and Insurance Committee, which White Chairs, in a 14-1 vote last week. The House Appropriations committee is now considering it.