Gender-Affirming Care For Trans Adults Threatened By Ruling On Medicaid Coverage

The appeals court ruling comes less than a year after the Supreme Court greenlit bans on care for trans youth.

A critical court decision on Medicaid coverage in West Virginia this week is troubling legal experts, who say the ruling could further attack access to gender-affirming health care for trans adults.

On Tuesday, the 4th U.S. Circuit Court of Appeals became the first federal appellate court to uphold a Medicaid ban on coverage for surgeries for transgender adults, less than a year after the Supreme Court’s ruling in U.S. v. Skrmetti allowed a Tennessee ban on gender-affirming care for minors to go into effect.

In a unanimous decision, a panel of three Republican-appointed judges overturned a previous decision that found that West Virginia’s 2004 statute violated the Constitution’s equal protection clause.

Instead, the panel ruled that West Virginia’s Medicaid exclusions do not discriminate against transgender people, and rather that the law applies only to specific surgical procedures to alleviate gender dysphoria.

The judges cited two major Supreme Court rulings from last year that curtailed trans and reproductive rights.