2022 ruling that Houston County, in rural Southern Georgia, discriminated against Anna Lange, an 18-year veteran of the county’s sheriff’s office, when it refused to amend a decades-old exclusion on gender-affirming care in its employee health insurance plan.Under the exclusion, county dollars are prohibited from being used, either directly or indirectly through insurance, to pay for treatments meant to assist someone in transitioning from one gender to another.Following a two-day trial after that ruling, a jury found that Lange had been unfairly discriminated against due to the insurance exclusion, and awarded her $60,000 in damages.Houston County appealed the lower court’s decision to the 11th Circuit, seeking to overturn it. The appeals court subsequently found that the that a health insurance provider can be held liable under Title VII for denying coverage for surgical interventions — which might otherwise be offered to cisgender individuals — due a person’s transgender identity.Additionally, the 11th Circuit found that the lower court did not abuse its discretion when it granted a permanent injunction blocking the county from enforcing the health plan exclusions for gender-affirming care.Referencing Supreme Court precedent finding that anti-LGBTQ discrimination in the workplace is inherently a form of sex-based discrimination, the appeals court found that the insurance exclusion in Houston County’s plan was a form of unlawful discrimination.“The Exclusion is a blanket denial of coverage for gender-affirming surgery,” Circuit Judge Charles Wilson wrote for the 11th Circuit.
