One of the plaintiffs involved in the case, Julia McKeown, said she’s “pleased” with the court’s decision and is excited for the case (Kadel v. Folwell) to move forward.

“Transgender state employees, like myself, deserve the same access to benefits and equal treatment as any other employee,” continued McKeown, who is an assistant professor at North Carolina State University. “We dedicate our time and talent to improve the well-being of the state and our neighbors, yet we are deprived of medically necessary and often life-saving health care services. This is an injustice.”

As a brief background on the case, plaintiffs Max Kadel and Julia McKeown were represented by Lambda Legal and the Transgender Legal Defense and Education Fund in the federal suit. They argue that the blanket refusal to cover care is in violation of the Affordable Care Act’s (ACA) ban. On the other hand, the state argued it had protection from lawsuits being brought against it without its consent. (What’s known as sovereign immunity.) The state has also argued that the nondiscrimination ban in the ACA wasn’t clear.

The sticking point between the two sides essentially boils down to: Is it discrimination to outright refuse to cover gender-affirming health care to trans people? (Obviously, it is.)

The Supreme Court didn’t issue remarks about the decline, which is the norm.

In a press release, Lambda Legal Senior Attorney Omar Gonzalez-Pagan said that entities including the state health plan must be “held accountable when they discriminate and violate people’s rights. Today’s decision protects the rights of marginalized people, including LGBTQ people and people living with HIV, to seek justice and obtain relief in court if they are subjected to health care discrimination.”

In the big picture, why does this sort of thing matter so much? Because your health care shouldn’t depend on your employer or health insurance provider. People shouldn’t need to choose between having a job that offers financial stability and a job that offers a trans-inclusive health care plan. It’s also important to remember that gender-affirming care is lifesaving, necessary medical care. It’s not an option for trans people who need it.

The right to feel safe, happy, and comfortable in one’s body should be a basic, fundamental position everyone can support, but unfortunately, a concerning number of people give credence to the anti-trans hysteria spewed by Republicans. No one—not trans people, not physicians, not mental health professionals—take gender-affirming decisions lightly. That should be all insurance providers need to know. 

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