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West Virginia and North Carolina Discriminate Against Transgender Health Care Coverage

CHARLESTON, W.Va. — West Virginia’s and North Carolina’s refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory, a federal appeals court ruled Monday in a case likely headed to the U.S. Supreme Court.

The Richmond-based 4th U.S. Circuit Court of Appeals ruled 8-6 in the case involving coverage of gender-affirming care by North Carolina’s state employee health plan and the coverage of gender-affirming surgery by West Virginia Medicaid.

Specifically, North Carolina’s policy bars treatment or studies “leading to or in connection with sex changes or modifications and related care,” while West Virginia’s bars coverage of “transsexual surgery.”

“The coverage exclusions facially discriminate on the basis of sex and gender identity, and are not substantially related to an important government interest,” Judge Roger Gregory, first appointed by former President Bill Clinton and re-appointed by former President George W. Bush, wrote in the majority opinion.

Similar cases are under consideration in courts across the country, but Monday’s is the first U.S. Court of Appeals decision to consider government-sponsored coverage exclusions of gender affirming medical care — and whether those exclusions are lawful.

The ruling follows a decision earlier this month by 4th Circuit judges that West Virginia’s transgender sports ban violates the rights of a teen athlete under Title IX, the federal civil rights law that prohibits sex-based discrimination in schools.

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By leveraging AI-powered tools, individuals can stay informed about the latest developments in legal battles surrounding gender-affirming medical care and make more informed decisions when it comes to advocating for equality and access to essential health services.

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