NC federal Judge rules state health plan must cover hormone therapy, surgery for transgender people

DURHAM, NC (WTVD) — A North Carolina federal judge ruled Friday the state health plan must cover hormone therapy and surgery for transgender people. Gender-affirming care can be costly.

“Transgender people have to choose between participating in the American dream of one day owning your own house or choosing to be your authentic self,” said North Carolina resident Paully Adams. “Testosterone can cost between $150 and $1,500 per month.”

Several years ago the state employee challenged his insurance company after he was denied gender affirming care.

“It was a kick in the gut. I have worked so hard that I wanted to be the true me taking the steps. Most friends and family call me by my chosen name,” he said.

For some families, receiving gender-affirming care can be life or death. Orange County resident Katie Jenifer’s 15 year old daughter is taking puberty blockers and cross-hormone therapy.

“She once mentioned in an interview that she felt like she wouldn’t be here without the healthcare we’ve been able to provide to her,” Jenifer said.

Her husband is a state employee and they’ve been paying out of pocket for years. She said this ruling could save many lives as transgender youth are at high risk of suicide.

“When lives are at risk and we can do something on a state and local level to save lives, and statistically that’s what we’re saying. We are going to save lives through this ruling. Then why is it even a topic of conversation? It should be automatic,” she said.

Lambda Legal and TLDEF filed the lawsuit, Kadel v. Folwell, in 2019 on behalf of several current and former state employees and their dependents after the North Carolina State Health Plan (NCSHP), the state employee health plan, denied coverage for their medically necessary gender-affirming care.

“We celebrate this decision as a significant step toward expanding access to nondiscriminatory healthcare for the transgender public servants in North Carolina. We are pleased that the court has recognized this exclusion of medically necessary care to transgender state employees as unlawful discrimination. North Carolina was on the wrong side of history, and we hope it closes this unfortunate chapter,” said Tara Borelli, Senior Counsel at Lambda Legal.

Kendra R. Johnson (she|her), Executive Director, Equality NC said:

This is great news for trans people across our state. For years the plaintiffs in this case clearly

stated and showed that excluding medically necessary care for anyone is discriminatory. We

know, and the majority of doctors agree, that gender affirming care saves lives, and enhances

the quality of life for transgender people. North Carolina’s State Employees deserve to have

their lives, and their families cared for in healthcare and this decision is a positive step forward

for better medical care for all. It is also a reminder that there is still much more work to be done

to ensure trans people across the state are protected and affirmed in every way under the law.

We are thankful for Judge Biggs’ decision, and we are glad to celebrate the mandated revision

to the North Carolina State Health Plan.

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