D.H. and John Doe are transgender teenagers who require male chest reconstruction surgery to treat their gender dysphoria. Arizona is refusing to cover this medically necessary treatment because of a categorical exclusion on covering surgical treatments for gender dysphoria in the state’s Medicaid regulations.

On September 26, 2016, the mother of a transgender teenaged boy who was admitted into Rady Children’s Hospital-San Diego (RCHSD) for inpatient care filed a lawsuit against the hospital for discrimination against her son, Kyler. One day into his 72-hour stay, and after several failed attempts by his mother to correct the discrimination by the hospital, the hospital’s psychiatrist determined that despite his serious mental health issues, Kyler should be discharged early. About five weeks later, Kyler died by suicide.