A Georgia county won’t foot the bill for trans surgery

Anna Lange – Photo: Transgender Legal Defense and Education Fund. WIN METRO WEEKLY’S “FRIDAY NIGHT COCKTAILS.”

A Georgia county has asked a federal appeals court to overturn a ruling that it discriminated against a transgender sheriff’s deputy when it denied her insurance coverage.

In June 2022, Marc Treadwell, Judge of the U.S. District Court for the Middle District of Georgia, ruled that Houston County had discriminated against Anna Lange, a 16-year veteran of the sheriff’s office, when it implemented a decades-old exclusion regarding the health of its employees unamended plan that prohibits the use of county funds to fund surgical treatments to help someone transition from one gender to another.

The county had already been warned by its insurer in 2016 that the exclusion was likely discriminatory and violated patient protections under the Affordable Care Act.

But county commissioners voted to keep the exclusion in place, ABC News reports.

In 2018, Lange informed her boss, Sheriff Cullen Talton, of her intention to transition and dress in accordance with the department’s standards of grooming for women.

Talton told Lange he “did not believe in gender reassignment” and warned her to develop a “tough skin” to withstand possible harassment from colleagues, but ultimately allowed her to present as a woman while working.

In 2019, Lange asked county commissioners to change the employee insurance plan to cover the cost of gender confirmation surgery, but was rebuffed.

She then went to court on the grounds that the insurance exclusion was unconstitutional. She ultimately had to pay for the surgery out of pocket, even though her doctors confirmed that the procedure was medically necessary to treat her gender dysphoria.

Treadwell ruled that the county’s employee health insurance exclusion was a form of sex discrimination – relying on the same reasoning the U.S. Supreme Court used in a 2020 employment discrimination ruling – , but also found that there was insufficient evidence to say whether the district had intentionally discriminated against Lange.

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Treadwell then ordered a civil proceeding to determine whether Lange was entitled to damages to compensate her for the financial costs of performing the operation.

After a two-day trial in September 2022, a jury found in Lange’s favor and awarded her $60,000 in damages for discrimination she suffered due to her denial of necessary medical care.

Houston County has since appealed the decision, arguing that the Supreme Court case cited by Treadwell prohibits firing people based solely on their gender identity and has nothing to do with health insurance coverage.

The county’s attorneys also argue that the surgical exclusion is not discriminatory because the county’s employee health plan covers other transition-related treatments that Lange could benefit from, such as hormone therapy and visits to an endocrinologist.

“We have a plan that Sgt. Lange got, just like every other county employee and sheriff’s employee,” Patrick Lail, an attorney representing the county, argued before a panel of the 11th U.S. Circuit Court of Appeals earlier this month.

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Lange’s lawyers argued that the U.S. Supreme Court ruling cited by Treadwell made it clear that anti-transgender discrimination is a form of gender discrimination, and therefore Lange is entitled to damages.

They pointed to six other court rulings in other counties that agree with Treadwell’s decision.

The U.S. Department of Justice intervened in the case on Lange’s behalf, saying the government has an interest in protecting the rights of transgender people and upholding the prohibitions against sex discrimination contained in Title VII of the Civil Rights Act of 1964.

In a statement, David Brown, legal director of the Transgender Legal Defense and Education Fund, which is representing Lange, said: “This is a simple case. The Supreme Court has found that an employer who offers unequal benefits based on sex violates Title VII.”

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Lange, for her part, expressed confidence after the appeals court hearing that both Treadwell’s verdict and the jury’s verdict would stand. “The law is clearly on our side,” she said.