The Biden administration is trying to force taxpayer-funded gender transition surgeries and interventions in Florida, challenging the state's block on Medicaid coverage for the procedures.

The Department of Justice and Department of Health and Human Services filed a brief in the 11th Circuit Court of Appeals arguing that the state violated Obamacare and Medicaid law by prohibiting taxpayer coverage for gender transitions.

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The Medicaid coverage ban in Florida applies to both adults and children.

"Florida’s exclusions target transgender people and prevent them, because of their sex assigned at birth, from receiving care available to other Medicaid beneficiaries," the Biden administration brief stated, citing "nondiscrimination requirements" in Obamacare. The brief said the federal government has an obligation to "vindicate sex-based denials of equal protection of the laws."

The Biden administration brief also cited the Supreme Court's ruling in Bostock v. Clayton County, written by Justice Neil Gorsuch, which changed the definition of "sex" in Title VII of the Civil Rights Act to include transgender identity claims.

Lawyers for the government argue that, despite this not being a Title VII case, "the challenged exclusions discriminate based on sex because they discriminate based on transgender status," using Bostock as the basis of the argument. The heavy reliance on Bostock is part of a broader Biden administration effort to apply the case's reasoning to every aspect of federal law, outside the bounds of Title VII.

In June, U.S. District Court Judge Robert Hinkle, an appointee of President Bill Clinton, ruled that Florida's measure prohibiting Medicaid coverage for cross-sex hormones and puberty blockers violates federal law and the equal protection clause of the U.S. Constitution. The decision prompted Florida's appeal.

In his ruling, Hinkle also added that "the record includes no evidence that these treatments have caused substantial adverse clinical results in properly screened and treated patients." However, there is a large and growing field of evidence to the contrary.

"Whether a Medicaid beneficiary can access a treatment such as testosterone depends on the patient’s sex assigned at birth," the Biden administration brief said this week, citing Hinkle's decision. "If the beneficiary is ‘a natal male, the treatment is covered.’ But if the beneficiary ‘is a natal female, the treatment is not covered.'"

In October, Florida argued the case was about whether taxpayer dollars should be used for these medical procedures.

“It’s a health and welfare question; it’s a medical policy issue,” the state's brief said. “It’s an area where the state gets to draw the line between what’s permissible and what isn’t."

Florida "decided to deny Medicaid reimbursement for the treatments," it continued. "That’s a decision the state gets to make. And given the evidence (or lack thereof) supporting the treatments, its decision was reasonable.”

The lawsuit was originally filed against the Florida Agency for Health Care Administration last year by two adults and two children claiming transgender identity.

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The case has brought the attention of several outside parties, including 18 Republican state attorneys general who filed a brief urging the 11th Circuit to overturn the lower court ruling, and another brief from 20 Democratic attorneys general asking the court to uphold it.

The Florida legal drama has also inspired advocacy organizations and medical organizations from across the country to file briefs.