Trans people win in major decision on health care access that could go to Supreme Court

A U.S. appellate court ruled today that North Carolina and West Virginia have been discriminating against transgender people by failing to cover gender-affirming care.

The U.S. Court of Appeals for the Fourth Circuit had taken on two cases concerning gender-affirming care access in both states. Kadel v. Folwell challenged the exclusion of trans government employees from gender-affirming healthcare coverage, while Anderson v. Crouch opposed the exclusion of low-income trans people from the state’s Medicaid program.

Related:

Appeals court overturns West Virginia’s trans sports ban

… and the U.S. Supreme Court has previously declined to hear similar cases.

“The North Carolina State Health Plan and the West Virginia Medicaid Program discriminate on the basis of gender identity and sex in violation of the Equal Protection Clause,” said the judges representing the majority ruling in the order.

Stay connected to your community

Connect with the issues and events that impact your community at home and beyond by subscribing to our newsletter.

Daily

Weekly

Good News

Due to the similarity of both cases, they were combined into one ruling, which affirmed the decision of the North Carolina district court and the West Virginia district court that refusing to cover transgender individuals constitutes discrimination. Eight judges supported the ruling, and six opposed it.

The plaintiffs in both cases were represented by Lambda Legal, alongside other legal firms.

“West Virginia’s denial of medically necessary care just because of who I am was deeply dehumanizing. I am so relieved that this court ruling puts us one step closer to the day when Medicaid can no longer deny transgender West Virginians access to the essential healthcare that our doctors say is necessary for us,” said Shauntae Anderson, the plaintiff in Anderson v. Crouch.

“I am pleased with this powerful court victory not only for myself but for all other state employees who have been discriminated against across North Carolina. As government employees, all we want is equal access to healthcare, but we were denied just because we are transgender,” said Julia McKeown, an associate professor at the College of Education at North Carolina State University.

According to the Associated Press, at least two judges expect this case to go up to the Supreme Court. It is unclear when or if this will take place, as the Supreme Court has a history of refusing to hear cases related to transgender issues.

Dissenting judges varied in their reasoning. Some argued that refusing to cover transgender individuals does not constitute sex-based discrimination.

“These arguments, whether alone or in combination, fail to show that the coverage exclusion constitutes an equal protection violation. What plaintiffs propose is nothing less than to use the Constitution to establish a nationwide mandate that States pay for Emerging gender dysphoria treatment,” said Judge J. Harvie Wilkinson III.

Tara Borelli, Lambda Legal senior legal counsel and lead lawyer on both cases, said, “We are pleased with the Court’s decision, which will save lives. It confirms that discriminating against transgender people by denying critical medical care is not only wrong but unconstitutional. No one should be denied essential health care, but our clients in both cases were denied coverage for medically necessary care prescribed by their doctors just because they’re transgender.”

The U.S. Court of Appeals for the Fourth Circuit also ruled in favor of transgender rights earlier this year by overturning a transgender sports ban in West Virginia.

Don't forget to share: