4th Circuit Court of Appeals says state health-care plans can’t exclude gender-affirming surgery

[essentialsaltes]

The decision came from a set of cases out of North Carolina and West Virginia, where state officials argued that their policies were based on cost concerns rather than bias. The U.S. Court of Appeals for the 4th Circuit rejected that argument, saying the plans were discriminating against trans people in need of treatment.

It’s the second ruling in favor of trans rights this month from the 4th Circuit, a once-conservative court that has become a trailblazer in the realm of transgender rights. The court was the first to say trans students had a right to use the bathrooms that align with their gender identity and the first to recognize gender dysphoria as a protected disability. Earlier this month, the court said a federally funded middle school could not ban a trans 13-year-old from playing on the girls’ track and field team.

Other states have banned hormonal treatment and surgery for trans minors; some have restricted care for transgender adults as well. Multiple other states have similar laws against insurance coverage for transition-related treatment.

The ruling could be appealed to the Supreme Court, which recently allowed Idaho to enforce a ban on gender-affirming care for minors. But the conservative-led court has been reluctant to engage on this issue, letting multiple 4th Circuit rulings in favor of transgender rights stand. The court also generally waits until there is disagreement between circuit courts before getting involved.

 

[Hans Blaster]

It’s the second ruling in favor of trans rights this month from the 4th Circuit, a once-conservative court that has become a trailblazer in the realm of transgender rights.

I wondered if this was due to a transformation of the court by Biden appointments and the answer would seem to be no. At least not from a simple analysis. Biden has appointed 3 of the 14 judges on the 4th Circuit who replaced 1 Clinton and 2 Obama appointed judges. The court has an even split by party of appointing president.

 

[AlexB23]

The decision came from a set of cases out of North Carolina and West Virginia, where state officials argued that their policies were based on cost concerns rather than bias. The U.S. Court of Appeals for the 4th Circuit rejected that argument, saying the plans were discriminating against trans people in need of treatment.

It’s the second ruling in favor of trans rights this month from the 4th Circuit, a once-conservative court that has become a trailblazer in the realm of transgender rights. The court was the first to say trans students had a right to use the bathrooms that align with their gender identity and the first to recognize gender dysphoria as a protected disability. Earlier this month, the court said a federally funded middle school could not ban a trans 13-year-old from playing on the girls’ track and field team.

Other states have banned hormonal treatment and surgery for trans minors; some have restricted care for transgender adults as well. Multiple other states have similar laws against insurance coverage for transition-related treatment.

The ruling could be appealed to the Supreme Court, which recently allowed Idaho to enforce a ban on gender-affirming care for minors. But the conservative-led court has been reluctant to engage on this issue, letting multiple 4th Circuit rulings in favor of transgender rights stand. The court also generally waits until there is disagreement between circuit courts before getting involved.

I'm gonna say this. As a somewhat liberal man who is all for saving the environment (good stewardship) and ethical treatment of humans, we got much more pressing issues compared to the trans stuff. If we want to stop Trump from getting into office, we should end this trans stuff, as it applies to <1% of the US population. I do not want to pay higher healthcare or medical taxes just so a 14 year old can change their gender. Higher taxes should go for fixing our roads, lowering tuition fees, and building up renewable infrastructure. Plus, imagine if one had a daughter. As a hypothetical father, I would not let my daughter use public restrooms if a random guy can waltz in proclaiming that he is a woman. If a 14 year old can not drink beer, and brains are not fully developed until age 25, changing gender is a bad idea. A trans surgery costs anywhere from $3,000-50,000*.

We agree on 85% of everything @essentialsaltes , but for this trans non-issue, I will have to disagree. The world has much more pressing issues such as global warming (+1.5C by 2030s), poverty, fascism and mental health crises. Remember 10 years ago? No one talked about the trans stuff. Transgenderism is a byproduct of individualism.

1.6 million / 330 million: How Many Adults and Youth Identify as Transgender in the United States?
*Cost data and info sheet: How Much Does Transgender Surgery Cost in 2024?

 

[Hans Blaster]

I wondered if this was due to a transformation of the court by Biden appointments and the answer would seem to be no. At least not from a simple analysis. Biden has appointed 3 of the 14 judges on the 4th Circuit who replaced 1 Clinton and 2 Obama appointed judges. The court has an even split by party of appointing president.

I got my hands on the actual ruling and the final count was 8-6. All of the 6 judges in the minority were appointed by Republicans and 7 of the 8 in the majority were appointed by Democratic presidents. The 8th judge was appointed to a permanent slot by GW Bush in 2001, but had been given a recess appointment by Bill Clinton that expired at the end of 2000.

 

[Pommer]

As a hypothetical father, I would not let my daughter use public restrooms if a random guy can waltz in proclaiming that he is a woman.

Hypothetically, I would agree, inasmuch as we’re both a product of our culture.
There are and have been cultures where a communal toilet is the “norm”., this seems very strange to us because in our culture this type of thing would be “asking-for-trouble”.

When’s the last time you remember talking to a stranger in a “public toilet”?

 

[camille70]

Hypothetically, I would agree, inasmuch as we’re both a product of our culture.
There are and have been cultures where a communal toilet is the “norm”., this seems very strange to us because in our culture this type of thing would be “asking-for-trouble”.

When’s the last time you remember talking to a stranger in a “public toilet”?

Mostly unfounded fear imo. They act like a stocky lumberjack looking guy with razor stubble in a dress is trying to use the restroom as a way to target women. Men dressed as MEN have assaulted women in women's restrooms for decades. A criminal is not going to follow the law for what restroom they are going to attack you in.

If anything the bans endangers trans people as they are more likely to be attacked by homophobic men if they have to use a men's restroom dressed as a woman. I can understand feeling uncomfortable about it, I'm not totally comfortable with it to be honest, but this is just a culture war issue to manipulate voters, IMO.

 

[AlexB23]

Hypothetically, I would agree, inasmuch as we’re both a product of our culture.
There are and have been cultures where a communal toilet is the “norm”., this seems very strange to us because in our culture this type of thing would be “asking-for-trouble”.

When’s the last time you remember talking to a stranger in a “public toilet”?

For your question, never. America breeds perverts, it seems.

 

[RileyG]

For your question, never. America breeds perverts, it seems.

Absolutely right! Trans issues are the least of our concerns now.

 

[AlexB23]

Absolutely right! Trans issues are the least of our concerns now.

Amen brother.

 

[rjs330]

This is a ridiculous ruling. Well, maybe not. Does Medicaid cover plastic surgery? If so then I guess it should cover transgender surgery. If not then it shouldn't be covering this. I hope this gets overturned if regular plastic surgery isn't covered.

 

[rjs330]

Mostly unfounded fear imo. They act like a stocky lumberjack looking guy with razor stubble in a dress is trying to use the restroom as a way to target women. Men dressed as MEN have assaulted women in women's restrooms for decades. A criminal is not going to follow the law for what restroom they are going to attack you in.

If anything the bans endangers trans people as they are more likely to be attacked by homophobic men if they have to use a men's restroom dressed as a woman. I can understand feeling uncomfortable about it, I'm not totally comfortable with it to be honest, but this is just a culture war issue to manipulate voters, IMO.

This kind of argument doesn't stand up to any scrutiny. It's a false argument. We have laws against robbing banks. Your argument would be, laws against robbing banks do t stop bank robbers. If they are going to rob a bank no law is going to stop them. So we shouldn't have laws against robbing banks.

Same goes for Domestic Abuse, Drunk Driving etc.

And we have actually seen and have evidence of perverted men claiming to be trans going into the women's restrooms or locker rooms and either assaulting or sexually harassing them.

It used to be that if women saw a men in their restroom they would leave and report it. Now they can't.

 

[Pommer]

The decision itself.
At 147 pages it’s a slog for all of us non-lawyerly folk but basically “if a surgical procedure is covered for non-transgender people, then transgender people are covered as well.”

 

[RileyG]

This kind of argument doesn't stand up to any scrutiny. It's a false argument. We have laws against robbing banks. Your argument would be, laws against robbing banks do t stop bank robbers. If they are going to rob a bank no law is going to stop them. So we shouldn't have laws against robbing banks.

Same goes for Domestic Abuse, Drunk Driving etc.

And we have actually seen and have evidence of perverted men claiming to be trans going into the women's restrooms or locker rooms and either assaulting or sexually harassing them.

It used to be that if women saw a men in their restroom they would leave and report it. Now they can't.

If you’re a man, don’t dress up as a woman! Simple

 

[RileyG]

Mostly unfounded fear imo. They act like a stocky lumberjack looking guy with razor stubble in a dress is trying to use the restroom as a way to target women. Men dressed as MEN have assaulted women in women's restrooms for decades. A criminal is not going to follow the law for what restroom they are going to attack you in.

If anything the bans endangers trans people as they are more likely to be attacked by homophobic men if they have to use a men's restroom dressed as a woman. I can understand feeling uncomfortable about it, I'm not totally comfortable with it to be honest, but this is just a culture war issue to manipulate voters, IMO.

Men don’t have to be dressing up as women to begin with. Accept your biological sex and move on.

 

[BCP1928]

And we have actually seen and have evidence of perverted men claiming to be trans going into the women's restrooms or locker rooms and either assaulting or sexually harassing them.

We have laws against assault and sexual harassment already.

It used to be that if women saw a men in their restroom they would leave and report it. Now they can't.

Who is stopping them?

 

[BCP1928]

Men don’t have to be dressing up as women to begin with. Accept your biological sex and move on.

They don't have to but there is no reason that they shouldn't if they want to. Who made you the Clothes Pope anyway?

 

[RileyG]

They don't have to but there is no reason that they shouldn't if they want to. Who made you the Clothes Pope anyway?

They bring it upon themselves when they make silly decisions.

 

[rambot]

I'm gonna say this. As a somewhat liberal man who is all for saving the environment (good stewardship) and ethical treatment of humans, we got much more pressing issues compared to the trans stuff. If we want to stop Trump from getting into office, we should end this trans stuff, as it applies to <1% of the US population. I do not want to pay higher healthcare or medical taxes just so a 14 year old can change their gender. Higher taxes should go for fixing our roads, lowering tuition fees, and building up renewable infrastructure. Plus, imagine if one had a daughter. As a hypothetical father, I would not let my daughter use public restrooms if a random guy can waltz in proclaiming that he is a woman. If a 14 year old can not drink beer, and brains are not fully developed until age 25, changing gender is a bad idea. A trans surgery costs anywhere from $3,000-50,000*.

We agree on 85% of everything @essentialsaltes , but for this trans non-issue, I will have to disagree. The world has much more pressing issues such as global warming (+1.5C by 2030s), poverty, fascism and mental health crises. Remember 10 years ago? No one talked about the trans stuff. Transgenderism is a byproduct of individualism.

1.6 million / 330 million: How Many Adults and Youth Identify as Transgender in the United States?
*Cost data and info sheet: How Much Does Transgender Surgery Cost in 2024?

View attachment 346824

This actually reads as a GREAT way of saying "Why are we withholding services and rights from Trans people? There are much bigger issues facing humanity and we should not be trying to make trans people's lives harder. They should have the same access to their necessary healthcare; same rights as citizens all that nonsense. Then we can focus on bigger issues".

And with that, I'd agree!

 

[rambot]

This kind of argument doesn't stand up to any scrutiny. It's a false argument. We have laws against robbing banks. Your argument would be, laws against robbing banks do t stop bank robbers. If they are going to rob a bank no law is going to stop them. So we shouldn't have laws against robbing banks.

Same goes for Domestic Abuse, Drunk Driving etc.

And we have actually seen and have evidence of perverted men claiming to be trans going into the women's restrooms or locker rooms and either assaulting or sexually harassing them.

It used to be that if women saw a men in their restroom they would leave and report it. Now they can't.

1) The fact that a person announced "Heeey...I'm transsexual and I'm coming into the tilet to assault you". is just silly.
2) The number of heterosexual attacks in those bathrooms outpaces trans attacks by. Well, they just can't really be compared.

3) I feel the same way about gun control! Put ALL those laws in placE!

 

[AlexB23]

This actually reads as a GREAT way of saying "Why are we withholding services and rights from Trans people? There are much bigger issues facing humanity and we should not be trying to make trans people's lives harder. They should have the same access to their necessary healthcare; same rights as citizens all that nonsense. Then we can focus on bigger issues".

And with that, I'd agree!

Well, why can't we get rid of the drinking age, and allow 10 year olds to vote? If a 17 year old can not vote, but a 9 year old can easily get trans surgery, then something is messed up in our country.

If we want to prevent Trump from getting into office, the left has got to let go of a few things (including the trans stuff), and do what is best for both sides and the health of our children instead of allowing kids to inject chemicals.

Remember the early 2010s, where both parties got along? Remember when the Democrats focused on ending the climate crisis? Remember when the Republicans abolished slavery? Pepperidge Farm remembers.

Bipartisanship (D & R): History of Bipartisanship | Bipartisan Policy Center
Paris Accords - Obama (D): President Obama: The United States Formally Enters the Paris Agreement
Abolishing Slavery - Lincoln (R): Abraham Lincoln | The White House

Pepperidge Farm Remembers, Futurama Scene (20 seconds)