Transgender federal workers sue Trump administration over insurance ban on their health care

The federal government promises health insurance as part of the bargain of public service. For transgender workers under President Donald Trump, that bargain now comes with an exception. The government will cover hormones and surgeries for many medical conditions, but not when they are used for gender transition. Five federal workers are challenging that distinction in court.

The employees filed a class action Monday against the Office of Personnel Management, accusing the agency of unlawfully stripping gender-affirming care from health plans covering federal and Postal Service workers, retirees and their families.

The lawsuit, filed in the U.S. District Court for the District of Columbia, argues that the exclusion amounts to sex discrimination under Title VII of the Civil Rights Act of 1964.

Related: Trump sued over denial of gender-affirming care to federal employees

“Our message to the Trump administration is simple: We’ll see you in court,” Human Rights Campaign Foundation President Kelley Robinson said. HRC is bringing the case on behalf of trans federal employees.

The policy has left workers facing denied claims, canceled treatment plans and bills reaching six figures, according to the complaint. The plaintiffs are identified via pseudonyms.

Gregory Goe, a transgender State Department employee, has received hormone therapy since 2018. His doctors determined that gender-affirming surgery was medically necessary. The procedure is no longer covered, and his surgeon will not schedule it without insurance. Goe faces more than $100,000 in costs, according to the lawsuit.

Charlotte Coe, a transgender State Department employee, alleges that her plan stopped covering hormone therapy, bloodwork, annual examinations and postoperative care. Patrick Poe, a Postal Service employee, covers his transgender daughter through his plan. Continuing her care without insurance could force the family to deplete its savings.

At issue are OPM directives prohibiting coverage for the “chemical and surgical modification of an individual’s sex traits,” including gender-transition services. The exclusion applies to adults and minors, including enrolled spouses and children.

OPM initially allowed exceptions for people already “mid-treatment” in a hormonal or surgical regimen. The complaint says the agency never clearly defined that term, leaving patients to navigate a separate and uncertain process. Beginning in 2027, insurers must eliminate those exceptions entirely.

Related: Federal workplace rights agency says Trump’s government can limit transgender employees’ bathroom usage

“This categorical denial of treatment for those who require continuing gender-affirming care is akin to denying continuing insulin treatment for someone with diabetes,” the lawsuit states.

The plaintiffs argue that the government is not excluding the treatments themselves. Similar hormones and procedures may remain covered when prescribed for cancer, menopause or other conditions. They become excluded, the lawsuit says, when the patient is transgender, and the treatment is connected to transition.

Federal health insurance is a term and privilege of employment, the complaint argues, and the Supreme Court held in its 2020 Bostock v. Clayton County decision that discrimination against transgender workers is discrimination because of sex.

The Williams Institute at UCLA School of Law estimates that at least 39,400 transgender federal employees, retirees and dependents could be affected.