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National Center for Transgender Equality Responds to Latest Fourth Circuit Ruling

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Contact Name
Ash Orr (they/he)

WASHINGTON, D.C. - Today, the U.S. Court of Appeals for the Fourth Circuit – covering West Virginia, Virginia, North Carolina, and South Carolina — upheld two prior court decisions mandating that North Carolina and West Virginia cease their discriminatory practices of excluding coverage for gender-affirming medical care for trans patients within their jurisdictions. 
“The Court’s ruling strongly emphasizes the importance of gender-affirming care for trans people, highlighting both the legal obligation and ethical responsibility to provide this care,” said Olivia Hunt, Policy Director at the National Center for Transgender Equality. 
The entire bench of the Circuit Court ruled decisively in favor of trans plaintiffs in two distinct legal battles, deeming the denial of medical coverage by both states discriminatory and unconstitutional. In one case, Kadel v. Folwell - brought forth by Lambda Legal and Transgender Legal Defense & Education Fund (TLDEF) alongside HWG LLP and McDermott, Will & Emery LLP - challenged North Carolina's blanket exclusion of coverage for gender-affirming medical care for transgender government employees and their dependents under the state health plan.  
The second lawsuit, Anderson (formerly Fain) v. Crouch - initiated in 2020 by Lambda Legal, Nichols Kaster, PLLP, and the Employment Law Center, PLLC - aimed at contesting West Virginia's refusal to cover gender-confirming surgical care for low-income transgender individuals enrolled in Medicaid.  

These decisions make it clear that healthcare for trans people is a crucial part of what allows us to thrive – and that this lifesaving care must not be denied.  
Decades of clinical research and experience show that trans people of all ages who have access to the care they need see a positive impact on their mental and physical health. Conversely, the denial of such care has been shown to have adverse effects on the health of transgender individuals, potentially exacerbating dysphoria, depression, anxiety, and self-harm,” Hunt went on to say. “We trust that this ruling serves as a reminder to policymakers nationwide that healthcare decisions should be driven by the needs of patients, their families, and healthcare professionals, rather than politicians.” 


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