The 4th U.S. Circuit Court of Appeals has ruled that state-run health insurance plans must include coverage for ‘gender-affirming’ surgeries, affirming the medical necessity of such treatments for ‘transgender’ individuals.

Byline: By yourNEWS Media Newsroom

A ruling from the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, mandates that health insurance plans operated by U.S. states must provide coverage for ‘gender-affirming’ surgeries for ‘transgender’ people. The decision upheld earlier rulings that found the exclusion of such surgeries in North Carolina and West Virginia’s state health plans constituted discrimination.

The court, in an 8-6 opinion, addressed policies that previously did not cover surgeries deemed essential for the treatment of ‘gender dysphoria’, claiming an inherent discrimination as these plans provided coverage for other medically necessary treatments like mastectomies for cancer patients but not for those undergoing gender transition.

Circuit Judge Roger Gregory, appointed by former President Bill Clinton, stated that excluding these surgeries was “obviously discriminatory” and highlighted the importance of equal medical treatment under the law. Meanwhile, officials from both states expressed their disagreement and intentions to challenge the ruling. North Carolina Treasurer Dale Folwell cited financial concerns about the sustainability of the state employee health plan, while West Virginia Attorney General Patrick Morrisey announced plans to appeal to the U.S. Supreme Court, emphasizing state rights in resource allocation for medical care.

The ruling originates from separate lawsuits by ‘transgender’ individuals challenging the exclusionary practices in their respective state insurance programs. Both cases were combined due to the similarity in legal issues involved.

Lambda Legal, representing the plaintiffs, praised the decision. Attorney Omar Gonzalez-Pagan called it a crucial affirmation that ‘gender-affirming’ care is vital and necessary medical treatment, and denying such care is both harmful and unlawful.

The broader context of this ruling fits into ongoing national debates and legal battles over healthcare rights for transgender individuals, particularly under-18s, across various U.S. states. Recently, the U.S. Supreme Court allowed Idaho to enforce a ban on gender-affirming care for minors, while an Ohio court temporarily blocked a similar ban, reflecting the contentious and evolving legal landscape surrounding transgender healthcare rights.