West Virginia and North Carolina's transgender care coverage policies discriminate, judges rule

A federal appeals court has ruled that West Virginia and North Carolina’s refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory. The Richmond-based 4th U.S. Circuit Court of Appeals ruled 8-6 in the case involving coverage of gender-affirming care by North Carolina’s state employee health plan and the coverage of gender-affirming surgery by West Virginia Medicaid. Both states appealed separate lower court rulings that found the denial of gender-affirming care to be discriminatory and unconstitutional. Two panels of three Fourth Circuit judges heard arguments in both cases earlier this year before deciding to intertwine the two cases and see them presented before the full court of 15.