Appeals court rules insurance policies don’t need to cover ‘transgender’ procedures

Refusing to cover “transgender” procedures in a health insurance policy does not violate the Civil Rights Act of 1964, an appeals court ruled Sept. 9.

The case in question was filed by Anna Lange, a deputy at the Houston County Sheriff’s Office in Georgia who is a man identifying as a woman. According to court documents, Lange sued the county because its insurance policy excludes drugs, services, or supplies for “sex changes.” He had hoped to undergo a sex change surgery, covered by the county.

Lange argued that he received “disparate treatment because of sex,” which violates Title VII of the Civil Rights Act. A district court sided with Lange, ruling that the insurance policy “violated Title VII on its face.” After the county appealed, a three-judge panel of the U.S. Court of Appeals for the 11th Circuit upheld the lower court’s ruling. However, the appeals court then voted to take the case en banc, before the full panel of judges.

The panel ultimately ruled 8-5 that the insurance policy does not violate Title VII. Writing for the majority, Judge Andrew Brasher noted in the court opinion that the exclusion of sex change services “does not treat anyone differently based on a protected characteristic.”

The judges’ decision drew on the Supreme Court of the United States’ (SCOTUS) ruling in United States v. Skrmetti, in which SCOTUS held that a Tennessee law banning hormones or puberty blockers for trans minors did not discriminate based on sex. The 11th Circuit cited SCOTUS’ decision, which states that “the law does not prohibit conduct for one sex that it permits for the other” and adds that the law does not “classify on the basis of transgender status,” contrary to Lange’s claims.

The appeals court concluded that the insurance policy does not facially discriminate under Title VII and reversed the district court’s ruling. The decision also vacated a permanent injunction and sent the case back down to the lower court for further proceedings in light of its ruling.