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Federal judge rules that trans sheriff’s deputy is entitled to equal health care in major victory

Anna Lange
Anna LangePhoto: Transgender Legal Defense and Education Fund

A U.S. District Court judge in Georgia says employers who refuse to cover gender-affirming health care for workers are in violation of U.S. civil rights law.

The ruling in Lange v. Houston County found that officials in Houston County, Georgia had violated protections afforded under Title VII of the Civil Rights Act of 1964 by repeatedly denying sheriff’s deputy Anna Lange insurance coverage for gender-affirming care under the county’s employee health plan.

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Chief Judge Marc Treadwell of the U.S. District Court for the Middle District of Georgia cited Supreme Court precedent in the case Bostock v. Clayton County: “In Bostock, the Supreme Court recognized that Title VII delivers a message ‘equally simple and momentous: [a]n individual’s … transgender status is not relevant to employment decisions.’ … Discrimination on the basis of transgender status is discrimination on the basis of sex and is a violation of Title VII.”

In the 33-page ruling, Judge Treadwell quoted Sgt. Lange’s supervisors describing her as “an exceptional employee who has ‘performed her duties as an investigator very well’ throughout her tenure.”

Lange came out to colleagues as transgender in 2017, after 10 years on the job. In seeking the care she was prescribed by her doctor, she found out that the health plan excluded gender-affirming procedures.

“It’s a huge relief to know that I can finally receive the medically necessary care that I was repeatedly and unfairly denied,” said Lange, represented in the case by The Transgender Legal Defense & Education Fund.

In addition to the civil rights violation in the case, Judge Treadwell noted in the ruling that the county’s own insurance administrator determined that excluding gender-affirming treatment from the county’s health plan was a violation of Section 1557 of the Affordable Care Act.

Section 1557 bans discrimination in health care, which the Obama administration interpreted to ban anti-LGBTQ discrimination. The Trump administration fought for years to interpret it as permitting anti-LGBTQ discrimination because sexual orientation and gender identity are not explicitly mentioned in it. A federal judge ruling that Section 1557 protects LGBTQ people from discrimination could help fight health care discrimination more broadly in the U.S.

According to the most recent United States Transgender Survey, one quarter of transgender people who live in the United States were denied insurance coverage for gender affirming care, while 55% percent of respondents were denied coverage for surgical procedures.

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