Medicaid Gender Surgery Exclusion to Get Fourth Circuit Look

The US Court of Appeals for the Fourth Circuit will hear oral arguments Tuesday on whether West Virginia’s Medicaid program can lawfully refuse to pay for gender-affirming surgeries.

The case focuses on a small part of the national political debate over whether states can remove or limit access to health care for transgender people—here, by making it impossible for them to afford treatments they say are medically necessary.

West Virginia’s program pays for some gender-affirming care, but it draws the line at paying for such surgeries as hysterectomies and vaginoplasties intended to conform transgender patients’ physical characteristics to their gender ...