Court Ruling on Gender-Affirming Surgery Coverage

A recent federal appeals court decision in Lange v. Houston County, Georgia highlights a growing legal trend: blanket exclusions for gender-affirming surgery in employer health plans may violate Title VII of the Civil Rights Act.

The court ruled that because transgender employees are the only participants who would seek this surgery, excluding it amounts to discrimination based on transgender status. Similar rulings have been made in other courts, signaling potential legal risks for employers who maintain such exclusions.

While there’s no specific federal law requiring coverage for gender-affirming surgery, recent cases show that plan language in this area should be reviewed carefully. Employers and plan sponsors may want to work with legal counsel to avoid unintended liability.

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