Home Part of States Newsroom
Ban on taxpayer-funded gender-affirming surgery for Indiana inmates heads to governor


Ban on taxpayer-funded gender-affirming surgery for Indiana inmates heads to governor

Mar 31, 2023 | 6:45 am ET
By Casey Smith Leslie Bonilla Muñiz
Ban on taxpayer-funded gender-affirming surgery for Indiana inmates heads to governor
Senators on Thursday approved a ban on inmate gender reassignment surgery. (Leslie Bonilla Muñiz/Indiana Capital Chronicle)

A bill to ban state and federal dollars from being used to provide Indiana inmates with gender-affirming sexual reassignment surgery advanced to the governor’s desk Thursday.

Senators voted 38-9 to move House Bill 1569, which restricts the Indiana Department of Correction (DOC) from paying for an offender’s reassignment surgery — even if recommended by a medical provider. 

The latest version of the bill, authored by Rep. Peggy Mayfield, R-Martinsville, does allow access to hormone therapies that are intended to make one appear or function as the opposite sex, however.

“(The bill) is focused solely on unproven, irreversible and life-altering surgeries that would be paid from Hoosier taxpayers,” said bill sponsor Sen. Stacey Donato, R-Logansport.

Taxpayer dollars can’t cover gender-affirming surgery costs

Currently, those incarcerated within DOC facilities, such as state prisons, are able to undergo the transition procedure. A DOC spokesperson said earlier this month that no inmates have done so yet, though.

Indiana’s Medicaid policy does not explicitly prohibit — nor allow — reimbursement for transition therapies or surgeries. Federal Medicaid guidelines additionally do not mandate states to cover sex reassignment surgeries.

Republican lawmakers who support the bill say they want to protect taxpayers from paying for an “unnecessary” procedure.

Democrats and LGBTQ advocates pushed back, holding that the bill is not about saving state resources, but rather part of a “hateful” GOP-backed agenda to enact anti-transgender legislation.

Ban on taxpayer-funded gender-affirming surgery for Indiana inmates heads to governor
Senate Minority Leader Greg Taylor, D-Indianapolis, talks to reporters on Thursday, Feb. 9, 2023. (Leslie Bonilla Muñiz/Indiana Capital Chronicle)

“So we can go ahead and make it seem like this is a saving-the-taxpayer-money issue,” Senate Minority Greg Taylor, D-Indianapolis, said Thursday. “But I think it’s about whether or not you agree with the surgery procedure or not. It shouldn’t matter.”

Mayfield said previously that about three dozen people in Indiana’s jails and prisons are currently receiving hormone therapy for gender dysphoria ― a clinical diagnosis describing the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics.

Another two dozen individuals are being assessed “as to whether accommodations need to be made.”

Surgical procedures like vasectomies and hysterectomies are — when medically necessary — provided by the state at no cost.

Although neither the DOC nor its third-party medical providers have provided sexual reassignment surgery to any inmates, that’s about to change.

As the result of a federal case settled in 2022, DOC will provide surgical care to Tonie Loveday, who is now undergoing pre-operative care. Loveday’s case is exempted from the bill — the provision does not apply to patients approved by the DOC for sexual reassignment prior to July 1.

A second federal case, Stillwell v. Dwenger, is still being litigated and remains undecided.

Watch out, GrubHub

Senators made minor changes to few bills Thursday — but more significantly altered a bill cracking down on third-party food delivery services like GrubHub and Uber Eats.

House Bill 1279 is intended to make it easier for dissatisfied restaurants to get out of contracts with delivery services, and to block those services from offering a restaurant’s food without its consent. 

Need to get in touch?

Have a news tip?

But it initially would’ve let a restaurant void its contract within 72 hours of telling delivery services of its intent, regardless of the contract’s terms. Lawmakers pulled back slightly, approving an amendment enforcing cancellation after a contract’s notice period is up, or 72 hours if there’s no time period specified in the contract.

“I believe in the freedom of contract and free enterprise,” amendment author Sen. Spencer Deery, R-West Lafayette, said. Stakeholders, he added, were actually more interested in “follow-through” after a cancellation.

The amendment therefore says delivery services need to take down all menus and ordering options, and stop all delivery activities, within the time frame specified in a contract or the 72 hours. The bill itself allows restaurants to sue if delivery services don’t comply.  

Lawmakers also approved a smaller tweak meant to ensure internet companies and search engines don’t get caught up by the proposal.

The Senate could consider the bill for final adoption as soon as Monday. Upon passage, it would need to return to the House for approval of the new edits before going to the governor’s desk.

Nearing the finish line?

With less than a month left until the end of the legislative session, a number of large bills — including priority measures and ones that have sparked controversy — are still in the works or have stalled altogether.

House Speaker Todd Huston said he’s “comfortable” with progress made so far on bills that are important to both his chamber and the Senate.

“We’re talking about all of those bills,” he said Thursday. “We’re having conversations around all of them.”

Lawmakers face their next set of deadlines in early April.

In the House, bills must be finalized in committee on April 11, then amended by the full chamber by April 13. Representatives have to greenlight bills to the governor or back to the Senate by April 17.

The Senate has until April 13 to advance bills from committees. Those measures then have to be amended by April 17 and voted out of the chamber by April 18.

Some bills will still need concurrence votes or hashed out in conference committees before being sent to the governor for a signature or veto.

Where are big priority bills?

Key bills still in committee that have not been assigned a hearing:

Senate Bill 1 (behavioral health), Senate Bill 6 (health care billing), Senate Bill 8 (prescription drug pricing), House Bill 1008 (anti-woke pension investing)

Bills still awaiting a committee vote:

Senate Bill 3 (tax review task force), Senate Bill 4 (public health funding boost), Senate Bill 5 (consumer data protection), House Bill 1002 (“reinventing” high school), House Bill 1003 (health reimbursements), House Bill 1004 (multiple health care changes), House Bill 1006 (mental health)

Bills still on second reading and pending amendments on the floor:

Senate Joint Resolution 1 (right-to-bail limits), House Bill 1005 (housing and tax financing)

As for the state’s next two-year spending plan, Senate Pro Tem Rodric Bray said Thursday his caucus likely won’t reveal its version of the state budget until sometime around April 12.

Senators plan to vote on the budget by April 18 — one day before the release of the state’s next revenue forecast. After that, leaders in the House and Senate will work together to finalize the plan before the April 29 Sine Die deadline, when all legislative work must come to a close.

“We’re already in some conversations (with the House) about what that (budget) looks like,” Bray said, adding that — despite desire in years prior to end the session a few days early — state lawmakers will likely be at the Statehouse closer to their final deadline. “You can’t make those decisions, of course, until the revenue forecast comes in, but we’ll do as much work as we can leading up to that. It is a very quick turnaround when we’ve got a north-of-$40-billion budget to sort out.”