Judge Finds Florida’s Trans Care Insurance Exclusion Unlawful
The court finds state employee insurance plan's exclusion violates trans workers' civil rights by denying them benefits granted to their colleagues.
A federal judge has ruled that Florida’s ban on gender-affirming care for adults who work as state employees is discriminatory and violates their civil rights.
Chief U.S. District Judge Mark Walker, of the Northern District of Florida, found that the ban — which takes the form of an insurance exclusion in the state employee health plan prohibiting coverage for “gender reassignment or modification services or supplies” — violates Title VII of the Civil Rights Act.
Title IX prohibits discrimination against employees and job applicants based on a variety of personal characteristics, including “sex.”
But the U.S. Supreme Court ruled, in a 2020 decision, that anti-LGBTQ discrimination is inherently a form of sex-based discrimination — and that principle has provided an opening for three current and former Florida state employees to challenge the insurance exclusion.
The three employees filed a lawsuit against the Florida Department of Management Services, which administers the state employee insurance program, in 2020.
In their complaint, they claimed the presence of the exclusion led to them being denied coverage for gender-affirming surgical treatments — leaving them with only two options: to pay out of pocket, or forego surgical interventions and delay their transition.
Lawyers for the plaintiffs noted that the exclusions on gender-affirming care have existed in Florida state employee health plans — as well as in other states’ employee insurance plans and plans adopted by private companies — for decades.
However, they argued that the exclusions in Florida’s plan end up providing fewer benefits and less compensation to their clients and other transgender individuals, in comparison to those granted to their cisgender colleagues.
The plaintiffs’ lawyers, from Southern Legal Counsel, the ACLU of Florida, and Legal Services of Greater Miami, argued that, without the exclusion, each of the three plaintiffs would otherwise have been able to obtain coverage for any care that had been deemed “medically necessary” by their personal physicians.
Siding with the plaintiffs, Walker found that health and pension benefits represent a crucial part of an employee’s compensation, so the practical effect of denying or reducing such benefits, based solely on the person’s assigned sex at birth, is denying that same employee an “employment opportunity” on the basis of sex.
Walker also ruled that treatments for gender dysphoria, like any other medical condition, should be based on an “individualized determination” of the unique physical and mental health needs of the patient, rather than blanket exclusions requiring a one-size-fits-all approach to medical care.
“As the Eleventh Circuit has held, ‘drawing a line between gender-affirming surgery and other operations, . . . intentionally carves out an exclusion based on one’s transgender status,'” Walker wrote in the August 1 decision.
“But an individual’s ‘transgender status is not relevant to employment decisions,” he added, quoting the 2020 Bostock v. Clayton County Supreme Court case. “Instead, discrimination on this basis ‘requires an employer to intentionally treat individual employees differently because of their sex.’ For this reason, the exclusion of state plan health insurance coverage for gender reassignment or modification services and supplies violates Title VII as a facially discriminatory policy.”
The court will schedule a trial at a later date to determine the amount of money that the plaintiffs should be awarded.
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