Lange v. Houston County
Lange v. Houston County, is a 2-1 decision requiring coverage of transgender surgery as demanded by a county employee seeking to transition from a man to a woman. No. 22-13626, 2024 U.S. App. LEXIS 11591 (11th Cir. May 13, 2024).
Only 15 precedents are cited by the majority decision, mostly not relating to transgender rights. It relies heavily on one decision by the U.S. Supreme Court: Bostock v. Clayton County, 590 U.S. 644 (2020).
As the dissent explains:
| “ | I'll start in the same place the majority opinion does—with Bostock v. Clayton County, 590 U.S. 644, 140 S. Ct. 1731, 207 L. Ed. 2d 218 (2020). In Bostock, the Court held that Title VII prohibits firing an employee "simply for being" transgender. Id. at 681. The Court explained that "[i]f [an] [] employer intentionally relies in part on an individual employee's sex when deciding to discharge the employee—put differently, if changing the employee's sex would have yielded a different choice by the employer—a statutory violation has occurred." Id. at 659-60. In light of this understanding of sex discrimination, the Court reasoned that "it is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex." Id. at 660.
Turning to the County's insurance plan, the challenged exclusion doesn't fit Bostock's rubric because nothing about the exclusion turns on Lange's sex. Unlike the employees in Bostock who were fired because they identified with a gender different from their natal sex, this health insurance plan does not deny medical coverage to participants "simply for being . . . transgender." Id. at 681. To be akin to Bostock, the policy would have to deny some or all coverage to transgender people. But it doesn't. The County's insurance plan covers transgender people and provides treatments for gender dysphoria. Lange's sex is not relevant to the County's insurer all. All that matters is whether Lange is asking the insurer to pay for the constellation of medical procedures known as a "sex change." |
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Lange v. Hous. Cty., No. 22-13626, 2024 U.S. App. LEXIS 11591, at *21-22 (11th Cir. May 13, 2024).