Lambda Legal and the Transgender Legal Defense & Education Fund (TLDEF) filed a lawsuit Monday on behalf of current and former North Carolina state employees, alleging discrimination against transgender persons enrolled in health care coverage.

The plaintiffs argue that because treatment of gender dysphoria is categorically excluded from the health care coverage, the defendants “deny equal compensation for equal work.”

TLDEF alleges harm suffered by the plaintiffs due to the categorical exclusion of coverage for medically necessary gender-conforming heath care. This harm includes the costs that plaintiffs have incurred to pay for the health care out-of-pocket, while other plaintiffs have had to forego the health care.

The complaint claims that:

[T]he North Carolina State Health Plan for Teachers and State Employees’s targeted discrimination against transgender enrollees, [] wrongly deems their health care needs as unworthy of equal coverage.

The lawsuit brings these claims on the basis of violation of the Equal Protection Clause of the Fourteenth Amendment, Title IX of the Education Amendments of 1972 and Section 1557 of the Affordable Care Act.