Transgender citizens of Minnesota and Wisconsin woke up to good news on Monday, September 24.


According to the Minnesota and Wisconsin federal courts, transgender people must be able to access the medically necessary care that’s prescribed to them by their doctor. This means insurance companies can no longer deny coverage for certain procedures or medications, based on religious or other reasons.

What Started the Conversation

Before this ruling, the Wisconsin Government Insurance Board’s Uniform Benefits prohibited coverage of “procedures, services, and supplies related to surgery and sex hormones associated with gender reassignment.”

In Minnesota, a nurse sued the state after her health insurance company refused to cover hormone therapy for her transgender son.

The Argument Against Transgender Care

One state argued that their reason for not wanting to grant medical protections to transgender people is because certain procedures, such as gender confirmation surgery, would reinforce cultural stereotypes about gender.

However, Judge Conley called this reasoning “unhinged from reality,” arguing that procedures will never be forced upon transgender people. Just like a cisgender woman who had a double mastectomy because of breast cancer can choose to get breast enhancement surgery or not, a transgender woman can choose to get gender reassignment surgery or not.

So to deny all trans people the option would mean a portion of the state’s population would “suffer from profound and debilitating gender dysphoria without the necessary medical transition.”

The Affordable Care Act Saves the Day

According to the Federal Care Act, Section 1557 says that any program receiving federal funding cannot discriminate care based on a person’s race, color, national origin, sex, age, or disability. Federal judges in both states found that “sex” includes the category of gender identity.

“Because Title VII, and by extension Title IX, recognize that sex discrimination encompasses gender-identity discrimination,” wrote U.S. District Judge Donovan Frank in the Minnesota case, “the Court concludes that Section 1557 also prohibits discrimination on the basis of gender identity.”