A judge for the US District Court for the Middle District of North Carolina found Friday in favor of transgender state employees who were denied gender-affirming healthcare coverage. Judge Loretta Biggs ruled that the state health plan must offer “medically necessary services for the treatment of gender dysphoria.”

The plaintiffs, represented by Lamda Legal and the Transgender Legal Defense & Education Fund (TLDEF), filed their complaint in 2019 and alleged that the refusal of coverage for gender-affirming healthcare by state employer healthcare plans violated the Equal Protection Clause of the Constitution and Title VII of the Civil Rights Act of 1964, by unlawfully discriminating based on sex and transgender status.

Biggs agreed, concluding:

Issues surrounding transgender healthcare evoke strong emotional and political opinions. … But politics and emotion are not admissible as evidence in a court of law. Plaintiffs’ doctors, their experts, every major medical association, and Defendants’ own third-party administrators all agree that, in certain cases, gender affirming medical and surgical care can be medically necessary to treat gender dysphoria. Defendants attempt to create scientific controversy in this uniform agreement through experts who mix their scientific analysis with hypothetical speculation and political hyperbole. Only science that is relevant, reliable, and offered by a qualified expert is admissible, however, and the admissible portions of Defendants’ expert’s testimony, even when taken in the light most favorable to Defendants, do not justify the exclusion at issue. Defendants’ belief that gender affirming care is ineffective and unnecessary is simply not supported by the record. Consequently, their categorical sex- and transgender-based exclusion of gender affirming treatments from coverage unlawfully discriminates against Plaintiffs in violation of the U.S. Constitution and Title VII.

Julia McKeown, an assistant professor in the College of Education at North Carolina State University, said following the ruling, “I am thrilled beyond measure for this powerful victory not only for myself but other transgender employees across the state.” She also noted, “As government employees, all we want is equal access to healthcare, but we were denied just because we are transgender.”