4th Circuit: Gender Identity Is A Protected Characteristic, Blocks State Coverage Bans

The 4th U.S. Circuit Court of Appeals ruled that bans on transgender care by Medicaid and state plans are unconstitutional, recognizing transgender people as a protected class and declaring such exclusions as discriminatory based on gender identity and sex. This decision upholds lower court rulings against North Carolina and West Virginia, which had denied gender-affirming care to transgender state employees and Medicaid recipients, dismissing state arguments that the exclusions applied equally to all individuals.