(The Center Square) – A federal appeals court has cleared the way for the North Carolina state health plan’s prohibition on coverage for treatment that is involved in gender transitioning surgeries.
The ban was enacted in the 1990s but has been entangled in court fights and has not been enforced since 2022, according to the state treasurer’s office.
However, the U.S. Supreme Court in June upheld a 2023 Tennessee law which bars health care providers from “prescribing, administering, or dispensing puberty blockers or hormones to minors for the purpose of enabling them to identify with a gender different from their biological sex,” according to the court.
The Supreme Court then sent the North Carolina case known as Kadel v. Folwell back to the 4th U.S. Circuit Court of Appeals in Richmond, Va., for reconsideration. The appeals court on Wednesday vacated its previous ruling blocking the ban and sent the case back to District Court.
The 4th Circuit decision Wednesday “reinstates the State Health Plan’s longstanding exclusion of transition-related treatments from coverage,” the North Carolina treasurer’s office said in a news release.
The State Health Plan covers an estimated 750,000, inclusive of retired and active teachers, state employees, and their dependents. It also includes current and former lawmakers, and higher education personnel.
In its ruling on the Tennessee case, Supreme Court Chief Justice John Roberts stated that recent developments on gender transition, “only underscore the need for legislative flexibility in this area.”
He cited a report commissioned by the National Health Service in England that called the evidence supporting the use of puberty blockers and hormones to treat transgender minors as “remarkably weak.”
Roberts added that there is “no good evidence on the long-term outcomes of interventions to manage gender-related distress.”
The appeals court ruling on the State Health Plan’s exclusion of on treatment for transition treatment does not bar other coverage for injuries or bodily harm caused by earlier transition procedures, the treasurer’s office said.
“Additionally, in 2021, the Plan’s Board of Trustees affirmed continued coverage for psychological assessment and psychotherapy treatment in conjunction with a diagnosis of or connected to gender dysphoria,” the treasurer’s office said in a release. “The reimplemented benefit exclusion does not exclude psychological assessment and psychotherapy treatment in these cases. “
The American Civil Liberties Union, which filed a legal challenge against Tennessee’s law, disagreed.
“Tennessee is home to over 3,000 transgender adolescents and the health care banned by this law is supported by the entire mainstream of the medical community,” the ACLU said in a statement after the Supreme Court ruling.
