Frequently Asked Employer Questions: State Health Plan and Gender Affirming Medical Services
Must the North Carolina State Health Plan provide transgender employees with gender affirming medical services (hormone therapy, surgery, and other affirming treatments)?
As of now, yes. A District Court judge has ruled in Kadel v. Folwell that refusal to cover gender confirmation procedures and treatment violates the Equal Protection Clause and Title VII of the Civil Rights Act on the basis of sex. The State Health Plain previously provided coverage for these services, but stopped in 2017. The State still has the ability to appeal this ruling, so stay tuned for any relevant updates.
The ruling serves as a reminder to all North Carolina employers that Title VII of the Civil Rights Act has sweeping implications both for day to day operations and higher level decision making. It prohibits employers from discriminating against workers on the basis of sex, as well as religion, race, color, or national origin. The ruling appears to be consistent with a 2020 opinion from the Supreme Court, Bostock v. Clayton, which held the Title VII prohibition on discrimination based upon sex also includes a prohibition from discrimination on the basis of sexual orientation or gender identity
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Full case citation: Kadel v. Folwell, 446 F. Supp. 3d 1 (M.D.N.C. 2020), aff’d sub nom. Kadel v. N. Carolina State Health Plan for Tchrs. & State Emps., 12 F.4th 422 (4th Cir. 2021), as amended (Dec. 2, 2021), cert. denied, 142 S. Ct. 861, 211 L. Ed. 2d 568 (2022).