Federal judges are considering whether the health insurance plan for North Carolina's state employees should cover gender affirming treatment. A transgender man is among those who sued the state, arguing the health plan illegally denied coverage for hormone therapies and chest reconstruction surgery even though he was diagnosed with gender dysphoria.
A lower court ruled in his favor. But in a hearing at the Fourth Circuit Court of Appeals Wednesday, the state health plan's attorney John Knepper argued the policy does not discriminate based on sex, and that insurance companies can choose which procedures to cover.
"Whether someone is transgender and whether someone has gender dysphoria, the illness, are separate things," he said.
Meanwhile, the plaintiffs' attorney Tara Borelli argued insurance companies don't have a choice in this case because the state uses discriminatory language to describe what it will not cover, including "sex changes or modifications."
"They're bound by that exclusion," she said, "And those are the explicit terms of the exclusion itself written into the handbook plan."
Federal appeals courts usually take at least a few months to issue a ruling.