Posted on 04/30/2024 7:55:36 PM PDT by SeekAndFind
The U.S. Court of Appeals for the Fourth Circuit ruled against two state-level health policies that exclude so-called “gender-affirming” treatments, teeing up potential review by the U.S. Supreme Court...
Judge Roger Gregory, an appointee of Presidents Bill Clinton and George W. Bush, wrote in his majority opinion that the policies’ exclusion of surgeries such as vaginoplasties for certain diagnoses violated the Equal Protection Clause of the 14th Amendment.
“The coverage exclusions facially discriminate on the basis of sex and gender identity, and are not substantially related to an important government interest,” he said.
The 8–6 decision affirmed lower court decisions against West Virginia’s Medicaid policy and the North Carolina State Health Plan for Teachers and State Employees. Both aimed to preclude coverage of procedures or treatments pursuant to attempts at changing one’s gender.
During oral arguments in September, at least two judges said it’s likely the case will eventually reach the U.S. Supreme Court.
Judge Gregory’s opinion rejected the idea that the policies didn’t discriminate on the basis of gender identity merely because they focused on diagnoses rather than individuals experiencing that condition.
“Appellants argue that the district courts’ equal-protection analyses were flawed because, they say, the exclusions distinguish on the basis of diagnosis,” he said.
He added that “in this case, discriminating on the basis of diagnosis is discriminating on the basis of gender identity and sex.”
Later in the opinion, Judge Gregory wrote that “gender dysphoria is so intimately related to transgender status as to be virtually indistinguishable from it. The excluded treatments aim at addressing incongruity between sex assigned at birth and gender identity, the very heart of transgender status.”
He later added that in “addition to discriminating on the basis of gender identity, the exclusions discriminate on the basis of sex.”
“Certain gender-affirming surgeries that could be provided to people assigned male at birth and people assigned female at birth are provided to only one group under the policy. Those surgeries include vaginoplasty (for congenital absence of a vagina), breast reconstruction (post-mastectomy), and breast reduction (for gynecomastia).”
Judge Gregory’s opinion encountered three separate dissents, including one in which Judge Harvie Wilkinson, an appointee of President Ronald Reagan, argued “the science behind gender dysphoria care is far from settled.”
He suggested the majority overstepped its authority in encroaching on state decisions about health care.
“Providing the best possible care to adults and youth struggling with gender dysphoria is a challenging task for our States,” he said.
“But it is one that they are entitled to perform without premature judicial interference.”
Andrea Picciotti-Bayer, director of the Conscience Project, said in a statement to The Epoch Times that the decision “cries out for reversal from the Supreme Court.”
She warned that Judge Gregory’s reasoning “surely will be cited in attempts to force private insurance plans to do the same.”
Judge Marvin Quattlebaum, an appointee of President Donald Trump, said the majority “improperly” declared statements from the Diagnostic and Statistical Manual of Mental Disorders and the World Professional Association for Transgender Health “to be facts.”
“Individually and combined, these missteps improperly stack the deck, effectively ignoring the fair-minded debate about the medical necessity and efficacy of the treatments the plaintiffs seek,” he added.
Lambda Legal, which challenged both states’ policies, declared victory.
“We are pleased with the Court’s decision, which will save lives. It confirms that discriminating against transgender people by denying critical medical care is not only wrong but unconstitutional,” Lambda Legal Senior Counsel Tara Borelli said in a press release.
“No one should be denied essential health care, but our clients in both cases were denied coverage for medically necessary care prescribed by their doctors just because they’re transgender.”
Argued: September 21, 2023 Decided: April 29, 2024
Before DIAZ, Chief Judge, WILKINSON, NIEMEYER, KING, GREGORY, AGEE, WYNN, THACKER, HARRIS, RICHARDSON, QUATTLEBAUM, RUSHING, HEYTENS, and BENJAMIN, Circuit Judges.
Affirmed by published opinion. Judge Gregory wrote the opinion, in which Chief Judge Diaz, Judge King, Judge Wynn, Judge Thacker, Judge Harris, Judge Heytens, and Judge Benjamin joined.
Judge Richardson wrote a dissenting opinion, in which Judge Wilkinson, Judge Niemeyer, Judge Quattlebaum joined, and in which Judge Agee and Judge Rushing joined except for part II.A.3.
Judge Wilkinson wrote a dissenting opinion.
Judge Quattlebaum wrote a dissenting opinion, in which Judge Agee, Judge Richardson, and Judge Rushing joined.
# Title Judge Duty station Born Term of service Appointed by
Active Chief Judge
48 Chief Judge Albert Diaz Charlotte, NC 1960 2010–present 2023–present Obama
30 Circuit Judge J. Harvie Wilkinson III Charlottesville 1944 1984–present 1996–2003 Reagan
33 Circuit Judge Paul V. Niemeyer Baltimore, MD 1941 1990–present — — G.H.W. Bush
40 Circuit Judge Robert Bruce King Charleston, WV 1940 1998–present — — Clinton
41 Circuit Judge Roger Gregory Richmond, VA 1953 2000–present 2016–2023 Clinton/G.W. Bush
44 Circuit Judge G. Steven Agee Salem, VA 1952 2008–present — — G.W. Bush
47 Circuit Judge James Andrew Wynn Raleigh, NC 1954 2010–present — — Obama
50 Circuit Judge Stephanie Thacker Charleston, WV 1965 2012–present — — Obama
51 Circuit Judge Pamela Harris Bethesda, MD 1962 2014–present — — Obama
52 Circuit Judge Julius N. Richardson Columbia, SC 1976 2018–present — — Trump
53 Circuit Judge A. Marvin Quattlebaum Greenville, SC 1964 2018–present — — Trump
54 Circuit Judge Allison Jones Rushing Asheville, NC 1982 2019–present — — Trump
55 Circuit Judge Toby J. Heytens Alexandria, VA 1975 2021–present — — Biden
56 Circuit Judge DeAndrea G. Benjamin Columbia, SC 1972 2023–present — — Biden
57 Circuit Judge Nicole Berner Baltimore, MD 1965 2024–present — — Biden
Maybe I read it wrong?
“But it is one that they are entitled to perform without premature judicial interference.”
Experimental human atrocity on kids is to be permitted until it is explicitly outlawed?
Weird how that threshold fails in every other form of medical care.
Robert Gregory [Clinton stooge] Albert Diaz [Obama stooge] Robert King [Clinton stooge] James Wynn [Obama stooge] Stephanie Thacker [Obama stooge] Pamela Harris [Obama stooge] Toby J. Heytens [Biden stooge] DeAndrea G. Benjamin [Biden stooge]
Gee, I guess that Dubya stooge John Roberts was right that politics plays no part in the decisions of the federal kangaroo courts...
Where is that in the Constitution?
Lately it seems the 4th circuit is trying to make up for the 9th circuit losing some of its left-tard insanity.
I’m fine with “Gender Affirming Medical Procedures”...
Asa long as it is just a DNA test: if it turns out it is XX chromosomes, then you are affirmed as female, if it is XY you are affirmed as male.
Forcing the cost of health insurance much higher. Meaning that critical treatments will not be affordable.
But try getting dental work covered on either Medicaid or Medicare.
Great question.
I can’t even think of a devil’s advocate position to answer that question.
The Ninth Circuit got Bidened, too - by one stooge-”judge”.
Then I guess they also think 12 year olds should drink, smoke
in public, and be welcomed into sex orgies.
Of course that ignores the 5-11 year olds.
What the hell are these justices drinking, smoking, or
shooting up?
For example, is this person really a lizard?
Which penumbra of the Constitution covers trannys?
Possibly...
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