Court rules Georgia county didn't discriminate by denying coverage of gender-transitioning surgery

ATLANTA (AP) — A federal appeals court has reversed previous court rulings that found a Georgia county illegally discriminated against a sheriff’s deputy by failing to pay for his gender-transitioning surgery.

In its ruling Tuesday, the 11th U.S. Circuit Court of Appeals found in an 8-5 decision that Houston County's policy of denying coverage did not violate the civil rights of sheriff's deputy Sgt. Anna Lange.

The decision of the full Atlanta-based appeals court overturned a three-judge appeals panel and a lower-court ruling that both found the refusal to cover Lange’s prescribed gender-transitioning surgery amounted to illegal sex discrimination under the Civil Rights Act of 1964.

“The County’s plan draws a line between certain treatments, which it covers, and other treatments, which it does not," wrote Judge Andrew Brasher, in an opinion joined by six other judges. "That line may or may not be appropriate as a matter of health care policy, but it is not facial discrimination based on protected status.”

The decision relies heavily on a June ruling by the U.S. Supreme Court that upheld Tennessee’s ban on gender-transitioning treatment for minors. That decision focused on the right to equal protection under the 14th Amendment, which requires the government to treat similarly situated people the same.

The 11th Circuit decision brings similar reasoning to civil rights law on employment discrimination, saying that a landmark 2020 decision that ruled transgender people couldn't be discriminated against in the workplace didn't apply to this health insurance question.

“The county’s policy does not pay for a sex change operation for anyone regardless of their biological sex," Brasher wrote.

Lange, an investigator for the Houston County sheriff’s office, had sued Sheriff Cullen Talton and the county in 2019 after he was denied coverage. The lower judge ordered the county’s insurance plan to pay for the surgery, and Lange eventually underwent the procedure. A jury awarded Lange $60,000 in damages in 2022. The county sought to undo Treadwell’s order and the damage award.