Published on May 29, 2024, 1:12 am

In a landmark decision, the U.S. Court of Appeals for the 11th Circuit has mandated that employers must include coverage for gender-transition surgeries in their employee health insurance packages. This ruling builds upon Title VII of the Civil Rights Act of 1964 which prohibits workplace discrimination on grounds of race, color, religion, sex, and national origin.

According to Judge Charles R. Wilson, who was part of the court’s majority opinion, any intention by the employer to treat an employee worse than other employees with parallel situations can be termed as discrimination under Title VII. Wilson convincingly referenced the Supreme Court’s verdict in Bostock v. Clayton County to highlight that differential treatment based on transgender status equates to discrimination due to their sex.

This historic case emerged when Anna Lange, a biological male identifying as a female and an employee at Houston County Sheriff’s Office for over a decade requested for gender-transition surgery in 2018. The healthcare plan provided by Houston County excluded gender-transition surgeries and related medical procedures from coverage. Lange consequently appealed to Anthem Blue Cross Blue Shield but was denied any support.

Lange initiated legal proceedings against Houston County and its Sheriff for alleged contraventions of Title VII, Title I of the Americans with Disabilities Act (ADA), as well as the equal protection clause of the U.S Constitution. A district court ruled favorably about her claim under Title VII but found no breach regarding ADA compliance by Houston County.

Amidst continued legal wrangling, Lange was awarded $60,000 in damages and effectively ensured that Houston County and its Sheriff’s Office would henceforth not implement exclusions related to gender-affirming surgeries in its healthcare plans.

Judge Wilson reiterated his earlier mentioned stance during this process saying that be it fact or law there existed little uncertainty about such exclusion connoting illegal discrimination against Lange and other transgenders within Houston County’s healthcare plan.

Despite this case presenting signs of major progress, it has also unveiled disparities in legal thought. Judge Andrew L. Brasher propounded an alternative interpretation arguing that refusing to cover gender-transition surgeries does not exemplify discrimination but instead is parallel to the insurance package excluding very expensive treatments.

Brasher expressed disagreement with the majority declaration which stated that by eliminating sex-change operations from its scope, the county’s policy was intentionally discriminatory towards transgenders. Brasher stressed that despite exclusion of sex-change surgeries, there wasn’t any unequal treatment stipulating grounds such as sex, gender nonconformity or transgender status.

Brasher’s primary argument lays on the line drawn by Wilson between gender-affirming surgery and other medical procedures, suggesting it as discriminatory- a claim Brasher disputed. He remarked that an employer cannot dodge liability for integrating discriminatory practices into some aspects of treatment and not others resulting in independent violations of Title VII for each instance.

This decision marks a significant shift in ensuring healthcare coverage for transgender employees under workplace insurance plans; however, is not without its critics who believe it does not treat everyone fairly and thus violates Title VII’s core principles.

Despite the ongoing discourse on this issue within judicial circles and society at large, organizations like the Transgender Legal Defense and Education Fund herald this ruling as a ‘historic win’, asserting the significant strides made toward embedding equality at workplaces across America.