A ban by the North Carolina State Health Plan (NCSHP) for Teachers and State Employees on paying for gender-confirming care, such as hormones and surgery, resulted in unlawful sex discrimination, the U.S. District Court for the Middle District of North Carolina decided. It's the latest decision among district and circuit courts seeking to interpret what is and is not discriminatory behavior based on sex.
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Exclusion Ruled Discriminatory
The NCSHP's blanket exclusion on paying for gender-confirming care "necessarily rests on a sex classification" because it would be impossible to determine if a particular treatment is connected to such care without considering a person's biological sex, the court said. The court relied on the U.S. Supreme Court's reasoning in Bostock v. Clayton County, which held that an employer can't fire an employee solely for being gay or transgender.
The recent North Carolina district court decision is one of several cases throughout the country disputing government health plans' limitations on paying for medically necessary transition-related care.
Federal Court Permits Christian Doctors to Deny Gender-Affirming Care
The 5th U.S. Circuit Court of Appeals ruled on Aug. 26 that the federal government cannot require health care providers to perform gender-transition procedures or abortions when the providers have a religious objection. In Franciscan Alliance v. Becerra, the court confirmed that the federal government cannot penalize or deny federal financial assistance because of a medical provider's failure to perform gender-transition services or abortions.
EEOC Guidance Struck Down
In October, the U.S. District Court for the Northern District of Texas concluded that the U.S. Equal Employment Opportunity Commission (EEOC) misapplied the Supreme Court's ruling in Bostock in the agency's June 2021 technical assistance document on LGBTQ workplace discrimination protections. The EEOC's guidance expanded the legal definition of sex discrimination to include sexual orientation and gender identity in employment situations. The guidance stated that workers have the right to use a bathroom that corresponds to their gender identity and the right to be free of harassment, including intentional and repeated use of the wrong pronouns.
Misgendering Nonbinary Employees on EEO-1 Form Is Common
The EEOC thus far has not added a box on the EEO-1 form to designate the gender of employees who are nonbinary. Employers unaware of the option to use the comments section to note nonbinary employees might unwittingly misgender employees as male or female as a result.
Trans Employees May Not Be Out at Work
Trans employees are less likely to be out at work, and they feel less safe and more excluded and discriminated against than their cisgender gay and straight colleagues, research shows. According to the Human Rights Campaign, the main reasons for not being out at work include fear of bullying and discrimination, fear of being stereotyped or tokenized, not wanting to make others uncomfortable, and concerns over losing relationships and career advancement opportunities.
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