Federal Appeals Court Rules West Virginia and North Carolina’s Refusal to Cover Transgender Health Care Discriminatory

The recent ruling by the 4th U.S. Circuit Court of Appeals on the refusal of West Virginia and North Carolina to cover certain health care for transgender individuals with government-sponsored insurance has sparked controversy and debate. The court deemed the denial of gender-affirming care as discriminatory, a decision that is likely to be appealed to the U.S. Supreme Court.

One of the plaintiffs in the case, Shauntae Anderson, a Black transgender woman and West Virginia Medicaid participant, expressed relief at the court’s ruling, calling the state’s refusal to cover her care “deeply dehumanizing.” West Virginia Attorney General Patrick Morrisey, on the other hand, announced his office’s intention to appeal the decision, stating that decisions like this one from a court dominated by Obama- and Biden-appointees cannot stand.

The case, which involves coverage of gender-affirming care by North Carolina’s state employee health plan and gender-affirming surgery by West Virginia Medicaid, has been a contentious issue. Both states appealed lower court rulings that found the denial of gender-affirming care to be discriminatory and unconstitutional. The case is expected to eventually reach the U.S. Supreme Court, as at least two judges during oral arguments indicated.

In North Carolina, a trial court had previously ruled in favor of transgender employees and their dependents, ordering the state plan to pay for medically necessary services, including hormone therapy and some surgeries. Similarly, in West Virginia, a federal judge ruled that the state’s Medicaid program must provide coverage for gender-affirming care for transgender residents.

The ongoing legal battle highlights the importance of access to essential healthcare for transgender individuals and the need to address discriminatory practices in healthcare coverage. As the case progresses to higher courts, the outcome will have significant implications for the rights and healthcare access of transgender individuals in West Virginia and North Carolina.