Baltimore City Hall – Photo: Smash the Iron Cage, via Wikimedia.
On Wednesday, the Baltimore City Board of Estimates voted to remove an exclusion from its employee health insurance plan that previously prohibited transgender city employees from obtaining coverage for gender confirmation surgery.
The Board of Estimates found that the transgender health care exclusions constituted a form of employment discrimination, under both Title VII of the Civil Rights Act and the Fairness for All Marylanders Act, which prohibits discrimination against people on the basis of gender identity. The board then unanimously voted to remove the exclusion.
The U.S. Equal Employment Opportunity Commission recently found, in a case out of Alaska, that states or municipalities that prevent transgender employees from obtaining coverage for gender confirmation surgery may be violating those employees’ rights under Title VII.
“I’m pleased that the city has done the right thing here,” FreeState Managing Attorney Jennifer Kent said in a statement after the vote. “We will continue to fight alongside employees who are transgender to ensure that all Marylanders are treated equally in their health insurance coverage.”
The issue was first brought to the city’s attention by the LGBTQ advocacy organization FreeState Justice after its client, the Rev. Merrick Moses, the citywide LGBTQ Community Liaison for the Baltimore City State’s Attorney’s Office, was denied coverage for medically necessary transition-related health care.
Historically, state or local governments have instituted bans on gender confirmation surgery because they deemed such procedures as cosmetic and not medically necessary. But over the years, a greater understanding of transgender health care has led people to understand that gender dysphoria is a real medical condition, and that transition-related health care, including hormones or surgery, are crucial to treating it.
Nineteen states and the District of Columbia currently prohibit transgender exclusions in health care. California, Massachusetts, and the District of Columbia also have provisions in place that explicitly transition-related care in Medicaid programs. In recent years, transgender residents in Iowa, Minnesota, and Wisconsin have sued their states over Medicaid exclusions, which were declared unconstitutional in the Iowa and Minnesota cases.
“This issue is about fairness,” Moses said in a statement. “Baltimore City’s transgender employees should be treated fairly and with dignity, including in health insurance matters. These gender confirmation surgeries are not cosmetic procedures. These matters are medically necessary procedures for the well-being of gender diverse persons.
“Baltimore City employees, who happen to be transgender, should be able to get the health care they need to live their best lives,” Moses added. “We are very happy that Mayor Pugh has taken a stand against transgender discrimination in health care. Our community just wants to be treated with fairness, dignity, and respect, like all other human communities.”
On Tuesday, South Carolina Gov. Henry McMaster signed a ban on gender-affirming care for transgender minors into law.
The law took effect immediately and officially made South Carolina the 25th state to place restrictions on gender-affirming care.
Under South Carolina's law, health professionals can be disciplined for prescribing gender-affirming treatments, such as puberty blockers, hormones, or gender confirmation surgery, to patients under the age of 18 seeking to transition.
The law also requires school administrators to notify parents or guardians if a child identifies by a gender that does not match their assigned sex at birth, or asks to use a name or nickname other than their legal name or pronouns that do not match the sex on their original birth certificate.
The Republican Party of Texas has approved a platform attacking a variety of LGBTQ rights, including marriage equality and same-sex parenting.
The party's 50-page platform, which delegates approved during the party's annual state convention in San Antonio on May 25, contains several planks meant to cater to social conservatives. While party platforms are not binding, they generally provide voters with an idea of the issues that will be prioritized by party leadership should they take power and a statement of a party's values.
Among the Texas GOP's various planks are opposition to marriage equality, including a full repeal of the Supreme Court's 2015 Obergefell v. Hodges decision that overturned various state bans on same-sex marriage, denial of marriage licenses to same-sex couples, and the refusal to recognize same-sex marriages that were legally performed in other states as valid.
A federal appeals court ruled that exclusions in health insurance plans barring coverage for gender-affirming care for transgender individuals violate Title VII of the Civil Rights Act, the federal law prohibiting sex-based discrimination.
In a May 13 ruling, the 11th U.S. Circuit Court of Appeals voted 2-1 to uphold a lower court's 2022 ruling that Houston County, in rural Southern Georgia, discriminated against Anna Lange, an 18-year veteran of the county's sheriff's office, when it refused to amend a decades-old exclusion on gender-affirming care in its employee health insurance plan.
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