Georgia to Cover Gender-Affirming Care for State Workers Under Settlement of Lawsuit

Georgia’s health insurance plan for state employees will now cover transition-related care under a settlement reached in a lawsuit brought by the Transgender Legal Defense and Education Fund.

The settlement, announced Thursday, comes as open enrollment is under way, TLDEF notes in a press release.

TLDEF and co-counsel Bondurant Mixson & Ellmore brought the suit last December on behalf of three public employees and the child of one, plus the Campaign for Southern Equality. Filed in U.S. District Court for the Northern District of Georgia, it argued that the exclusion of gender-affirming procedures under the Georgia State Health Benefit Plan is unlawful discrimination. The plan covers more than half a million Georgians, including employees of state agencies and public school districts, and their family members.

Under the settlement, those insured through the plan will immediately be able to access transition procedures. All insurance options offered by the state plan will carry this provision: “Transgender healthcare coverage generally includes medically necessary transgender surgery and/or other services as deemed medically necessary and appropriate by the member's treating medical personnel, consistent with the Standards of Care of the World Professional Association for Transgender Health, also known as WPATH, to treat gender dysphoria in its standards of care, as further explained in [the third-party administrator’s] medical policies.”

Also, the state will pay a financial settlement totaling $365,000 to the plaintiffs in the case: Micha Rich, Benjamin Johnson, and Jane Doe, who are employees of government agencies in Georgia and have been denied transgender-related health care; John Doe, who is Jane Doe’s young adult child and enrolled in the SHBP through his mother; and the Campaign for Southern Equality, a nonprofit organization dedicated to advancing LGBTQ+ civil rights throughout the South. The settlement covers a portion of their legal expenses as well.

Additionally, Anthem-operated plans will remove the exclusion for “services and supplies for a sex change and/or the reversal of a sex change,” and United-operated plans will remove the exclusion for “sex transformation operations and related services.” And the state is prohibited from re-creating a comparable exclusion.

“I am thrilled to know that none of my trans colleagues will ever have to go through what I did,” Rich, a staff accountant at the Georgia Department of Audits and Accounts, said in the press release. “I hope this is a new day for my beloved state of Georgia in its treatment of trans and nonbinary people.”

“In a year when transphobic extremists have pushed restriction after restriction for transgender people’s access to necessary health care, a development like this that will enable transgender Georgians to more easily access care is a huge victory,” added Holiday Simmons, director of healing and resilience for the Campaign for Southern Equality. “No government should be inserting itself into residents’ private medical decisions, and we’re encouraged to see that transgender people who are state employees in Georgia will no longer be denied coverage for life-affirming and even life-saving health care.”

This settlement follows a June 2022 victory in TLDEF’s lawsuit Lange v. Houston County, in which a federal court in Georgia ruled that an employer cannot exclude or deny coverage for transition-related medical treatments from its employee health insurance plan. it was the first such ruling in the South. Earlier that year, the state of Georgia also ended its exclusion for transgender-related health care in its Medicaid plan, after being sued in a federal case called Thomas v. Georgia Department of Community Health. And in 2018, the University System of Georgia settled a lawsuit, Musgrove v. Board of Regents, brought by TLDEF’s former trans health project director, in which it agreed to remove the trans health care exclusion from its employee health plan and pay the plaintiff $100,000. Employers around the country have lost or settled dozens of similar lawsuits in recent years.

Pictured, from left: Benjamin Johnson and Micha Rich