Two Trans Rights Healthcare Cases Head to Appeals Court

Two court victories for adult transgender healthcare are facing challenges in West Virginia and North Carolina. District courts in both states ruled that the exclusion of gender-affirming care from state insurance plans is discriminatory. Now state lawyers are contesting those rulings in the 4th US Circuit Court of Appeals, Reuters reports.

North Carolina and West Virginia are two of fifteen states that exclude coverage of gender-affirming care for state employees. Among the procedures listed are gender reassignment surgery and hormone therapy (with exceptions made in the latter case for non-transition-related treatment).

 In 2020, state employees sued, and in 2022, district courts ruled that targeting such coverage violated Fourteenth Amendment’s Equal Protection Clause, the Affordable Care Act, and the Medicaid Act. With the ruling now facing renewed legal challenges, plaintiffs in the West Virginia case have issued statements through Lambda Legal.

“Accessing Medicaid coverage for gender-confirming care is vital to the livelihood and survival of myself and other transgender community members,” said plaintiff Shauntae Anderson. “West Virginia’s choice to appeal with the hope to deny us life-saving medical care is both demoralizing and shameful.”

“I am outraged that West Virginia is wasting time and resources to appeal a court decision simply because our state would like to be allowed to discriminate against transgender West Virginians,” added plaintiff Christopher Fain.

On Wednesday, a panel of judges heard oral arguments, and they have decided to convene the full bench to hear both cases. This is a rare event for an appellate court. Senior attorney Tara Borelli, who is representing the plaintiffs for Lambda Legal, explained that “having both cases reviewed by the full court will allow for consistency across the issues in both appeals.”

The 4th Circuit is evenly split between 14 Democrat and Republican-appointed judges. But because Chief Circuit Judge Roger Gregory was appointed by Bill Clinton, it is considered to hold a narrow Democrat majority.

Beyond ordering a full convening of the court, a date for arguments in both cases will be decided at a later date.

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