U.S. court allows state bans on gender-affirming care for adults in unprecedented ruling

"It is not irrational for a legislature to encourage citizens to appreciate their sex and not become disdainful of their sex by refusing to fund experimental procedures that may have the opposite effect. - Judge Julius Richardson, Trump appointee, in the 35-page ruling documentation explaining the panel's justification for upholding the West Virginia law restricting Medicaid coverage."

"The unanimous decision came from a three-judge panel of the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, overturning a prior judge's ruling in 2024 that the statute violated anti-discrimination protections under federal law as well as the Constitution, with the panel stating that since the law applies to specific procedures, not specific individuals, it does not illegally discriminate."

The U.S. 4th Circuit Court of Appeals unanimously upheld a West Virginia law prohibiting Medicaid coverage for gender-affirming care procedures. A three-judge panel, all appointed by Republican presidents, reversed a 2024 lower court ruling that found the statute violated federal anti-discrimination protections and constitutional rights. The court determined the law does not illegally discriminate against transgender individuals because it restricts specific procedures rather than targeting specific people. The decision represents the first federal appeals court enforcement of such restrictions, following the Supreme Court's 2023 rejection of a challenge to Tennessee's ban on gender-affirming treatment for minors. The restricted procedures include chest reconstruction, genital alteration, and facial procedures.

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