Cosmetic surgery is not usually covered by Medicaid. Because nearly all cosmetic surgery is elective, taxpayer money can’t be used to pay for it. In a few very rare cases, where it is medically necessary, the procedure may be covered. In these rare cases, pre-authorization would be required. Examples of cosmetic surgery that Medicaid may cover include reconstructive surgery, such as breast reconstruction after cancer, and skin removal after weight loss in cases where the excess skin is causing health problems.
Gender-affirming hormone drugs include estrogen, anti-androgens, and progestins (feminizing hormones), as well as testosterone and other agents (masculinizing hormones). Under federal law, and subject to exceptions for a few drugs or drug classes, state Medicaid programs are required to cover all drugs from manufacturers that have entered into a rebate agreement with the Secretary of Health and Human services under the federal Medicaid Drug Rebate program. Twenty-five states reported covering gender-affirming hormones, and 10 of these states require prior authorization. Thirteen states said coverage was not addressed in state statute or policy, and three states—Alabama, Hawaii, and Texas —exclude coverage of gender-affirming hormone therapy.
I'm sure you can provide documentation to support your claims?
Cosmetic surgery
https://blogs.cornell.edu/learning/surprising-things-your-state-medicaid-may-not-cover/
Gender-Affirming Hormone Therapy:
https://www.kff.org/womens-health-policy/issue-brief/update-on-medicaid-coverage-of-gender-affirming-health-services/
You wanted proof well now you have it.