A federal appeals court has reversed a ruling that mandated gender-affirming care be covered by insurance, a decision that one judge says creates “lower-class citizenship” for transgender people.
The 11th U.S. Circuit Court of Appeals ruled Tuesday that Houston County sheriff’s deputy Sgt. Anna Lange must go to trial to prove her employer discriminated against her by excluding coverage for gender transition under her employee health plan.
“After everything I’ve been through, it’s crushing to know I will have to continue to fight to get what a jury already said I was entitled to,” Lange said in a statement. “This should never have happened to me, and it shouldn’t happen to anyone else.”
Lange filed her lawsuit in 2019 after she was denied coverage despite providing evidence of her medical needs supported by experts. A district court in Georgia ruled in 2022 that the denial violated federal civil rights law, and the U.S. Court of Appeals for the 11 Circuit affirmed that ruling in 2024.
The latest ruling reverses the previous and forces Lange to argue her case through trial, despite the county’s plan explicitly violating Title VII of the Civil Rights Act, according to 11th Circuit Judge Nancy Abudu. Abudu wrote in a scathing dissenting opinion that the majority’s ruling clearly “den[ies] medically necessary healthcare to an employee simply based on their sex.”
“I write separately to acknowledge the ongoing cultural war in which this Court, like courts before us, has had to participate,” Abudu said. “Our role is to ensure that, regardless of religious, political, or other ideologies, the law applies equally to all. The majority’s decision, unfortunately, undermines that goal and sets us up for yet another episode in our Circuit’s legal history where the majority just gets the outcome wrong, and the short- and long-term implications of its flawed decision cannot be ignored.”
“Despite persistent attempts to portray the advancement of transgender rights as tantamount to the degradation of the rights of cisgender women — in the same way propaganda encouraged men to believe that rights for women meant a diminishing of their own — the rights of these two groups are not and have never been mutually exclusive,” she added.
Abudu cited the U.S. Supreme Court ruling Bostock v. Clayton, which prevents employment discrimination against trans people under Title VII. It plainly states, “it is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex.”
Denying coverage for Lange’s care while allowing the same care for cisgender people treating other conditions is clearly sex-based discrimination, Abudu said, as it “traps transgender persons in the category of lower-class citizenship, outside of the protections afforded to cisgender individuals.”
“Instead of embracing a legal tradition (and mandate) of upholding the law to ensure all people are treated equally, or that any treatment is not rooted in a discriminatory purpose or practice, the majority opinion temporarily moves the needle back in the ongoing struggle for basic human dignity,” she wrote. “Accordingly, I respectfully dissent.”
This article originally appeared on Advocate: Appeals court ruling creates ‘lower-class citizenship’ for transgender people, judge says