A4TE to Full Eleventh Circuit: Affirm Decision in Georgia Transgender Health Care Discrimination Case   

[Atlanta, GA] – Today, Advocates for Trans Equality (A4TE) and co-counsel Willkie Farr & Gallagher and Cooper, Barton, & Cooper urged the full panel of the U.S. Court of Appeals for the Eleventh Circuit to affirm a lower court ruling that Houston County, Georgia discriminated against employee, Anna Lange, when it denied her health care coverage because she is transgender.   
 
“I still go to work, and I do my job like everyone else, but they don’t want me to have the same insurance coverage. All I ask is to be treated the same as every other employee, but Houston County discriminated against me simply because I am transgender,” said plaintiff Anna Lange, an investigator for the Houston County Sheriff’s Department. “I hope that this court will see this exclusion for exactly what it is, discrimination, and put an end to this once and for all.”  
 
“Today, we asked the full Eleventh Circuit to uphold the well-reasoned ruling of the district court that treating Anna Lange differently because she is transgender is unlawful and discriminatory," said Gabriel Arkles, Advocates for Trans Equality Co-Interim Legal Director. “It is disappointing that Houston County and the Sheriff’s Office have chosen to double-down on the discriminatory denial of medically necessary, evidence-based care for Anna Lange, even after spending roughly two million dollars of taxpayer money on lawyers to try to deprive her of care that costs orders of magnitude less."

“We are hopeful the full Eleventh Circuit will come to the same conclusion as the lower court in recognizing the County’s discriminatory treatment of Anna, and affirm the ruling in her favor so she can continue to get the medically necessary care she was denied,” said Jill Grant, partner at Willkie Farr & Gallagher LLP, who argued the appeal before the Eleventh Circuit. 

Sergeant Anna Lange has worked in law enforcement for over 25 years, with 17 of those years serving as a Sheriff’s Deputy in Houston County, Georgia. In 2017, Anna came out to her employer as a transgender woman and began living openly as her authentic self both at her workplace and community. Anna was diagnosed with gender dysphoria by her healthcare provider and was prescribed transition-related care as recommended by the World Professional Association for Transgender Health (WPATH). In her attempts to seek out this care, she learned that Houston County unlawfully excluded transgender health care from coverage under its employee health plan. Anna and her attorneys repeatedly attempted to persuade her employer to reconsider its decision, testifying before the Houston County Board of Commissioners and filing charges with the Equal Employment Opportunity Commission.  

In October 2019, TLDEF, now known as A4TE, filed a lawsuit on Anna’s behalf in the United States District Court for the Middle District of Georgia in Macon. In June 2022, relying on the U.S. Supreme Court’s 2020 ruling in Bostock v. Clayton County, Georgia, which held that transgender people are protected from discrimination under Title VII of the Civil Rights Act of 1964, the Georgia federal district court issued a landmark ruling holding that an employer cannot exclude or deny coverage for transition-related medical treatments from its employee health insurance plan. This was the first such ruling in the South. Houston County appealed the decision to the Eleventh Circuit despite having by then incurred legal expenses many times the cost of Anna’s health care. In March 2023, the Civil Rights Division of the Justice Department joined the case, filing a friend-of-the-court brief saying the United States of America agrees that any employer health plan with a trans health exclusion is always illegal under Title VII. Last May, a panel of the U.S. Court of Appeals for the Eleventh Circuit issued a decision 2-1 upholding the lower court’s ruling, but in August the court vacated that ruling and granted a rehearing of the case en banc.   

“It’s disappointing that Houston County is appealing this legally sound decision, especially considering the many other important challenges facing our Middle Georgia community, but we are hopeful the full Eleventh Circuit will come to the same conclusion and affirm the ruling in Anna’s favor,” said, Kenneth Barton, partner at Cooper, Barton, & Cooper LLP, who serves as co-counsel. 

Anna Lange is one of more than 500,000 transgender people who live in the South according to population studies conducted by the Williams Institute at the UCLA School of Law. One quarter of transgender people who live in the United States were denied insurance coverage for gender affirming care according to the most recent United States Transgender Survey. Additionally, 55% percent of survey respondents were denied coverage for surgical procedures.  

Last year, TLDEF, now known as A4TE, won a settlement in Rich v. Georgia, their lawsuit against the State of Georgia for denying coverage of transgender-related health care in the Georgia State Health Benefit Plan (SHBP), which covers more than half a million Georgians, including employees of state agencies and public school districts, and their family members.  

Gabriel Arkles, Ezra Cukor, Shayna Medley, Seran Gee, Anya Marino, Jack Einstein, and Kelly Parry-Johnson worked on the case for the plaintiff for Advocates for Trans Equality, along with the law firm Willkie Farr & Gallagher LLP in New York City (led by attorneys Wesley Powell, Jill Grant, and Catherine Fata); the law firm Cooper, Barton & Cooper in Macon, Georgia (attorneys Ken Barton and Devlin Cooper); and Professor Kevin Barry of the Quinnipiac University School of Law Legal Clinic in North Haven, Connecticut. Former TLDEF attorneys David Brown, Alejandra Caraballo and Noah Lewis also worked on the lawsuit.  
 
The case is Lange v. Houston County, Georgia.  

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About A4TE  

Advocates for Trans Equality (A4TE) is an organization that fights for the legal and political rights of transgender people in the United States. Introduced in July 2024 after the Transgender Legal Defense & Education Fund and National Center for Transgender Equality merged, A4TE is the largest trans-led advocacy organization in the U.S. and brings together experts, advocates, and communities to shift government and society toward an equitable future where trans people live joyful lives without barriers.