Trans Health-Care Cases Get Mixed Reception at Fourth Circuit

The Fourth Circuit judges hearing oral arguments Thursday seemed to fall into two camps on whether a North Carolina employee health plan and West Virginia Medicaid program unlawfully discriminate against transgender people.

The two plans exclude coverage for treatments intended to change a person’s sex and “transsexual” surgery—which the plaintiff participants say violates the 14th Amendment equal protection clause.

One camp, led by Judge Roger L. Gregory, appeared ready to rule that both provisions are facially discriminatory and subject to a heightened scrutiny standard in which the states must show that the exclusions serve important government interests.

Judge J. Harvie ...