Transgender activists and supporters protest potential changes by the Trump administration to federal guidelines issued to public schools in defense of transgender student rights, near the White House in February 2017.
Transgender activists and supporters protest potential changes by the Trump administration to federal guidelines issued to public schools in defense of transgender student rights, near the White House in February 2017.
Health insurance plans run by states must cover gender-affirming surgeries for transgender people, an appeals court ruled on Monday.
The 8-6 opinion from the Richmond, Virginia-based 4th U.S. Circuit Court of Appeals upheld two lower court rulings, which had found that North Carolina’s state employee health insurance plan discriminated against transgender people by not covering surgeries for “sex changes or modifications,” and that West Virginia’s Medicaid program discriminated by excluding “transsexual surgeries.”
Circuit Judge Roger Gregory, who was appointed by Democratic former President Bill Clinton, wrote for the majority that such policies were “obviously discriminatory” because they did not cover medically necessary treatments for transgender people that they did cover for others. For example, he wrote, they would cover a mastectomy to treat cancer but not gender dysphoria, the distress caused by identifying as a gender different from the one assigned at birth.
North Carolina Treasurer Dale Folwell said in a statement that the state employee plan was “facing the real risk of looming insolvency” and “cannot be everything for everyone.” He said he would “follow every legal avenue available to protect the Plan and its members.”
West Virginia Attorney General Patrick Morrisey said the state would appeal to the Supreme Court.
Monday’s ruling comes as part of a broader battle over health care for transgender people in the United States.
At least 22 Republican-controlled states have passed laws restricting gender-affirming care for people under 18, leading to legal challenges that have so far had mixed outcomes.
The Supreme Court earlier this month allowed Idaho to enforce its ban for now, while an Ohio court temporarily blocked a ban there.
