West Virginia, North Carolina Transgender Case Decision

North Carolina and West Virginia are being forced by the Fourth Circuit Court of Appeals to provide coverage for transgender operations in state health care plans. This ruling came in an 8-6 decision, which said that refusing to provide such operations goes against the Equal Protection Clause, which bans discrimination based on “gender identity and sex.”

This ruling will affect both state health care plans and Medicaid coverage. In North Carolina, the state health care plans did not cover transgender surgeries for employees of the state. In West Virginia, Medicaid did not cover these surgeries. These health programs have had to cover transgender operations since 2022, when lower federal district courts ruled that these plans must change.

Chief Judge Roger Gregory wrote the majority opinion, stating that these coverage plans are based on “a gender stereotype.” But Judge J. Harvie Wilkinson III wrote a dissenting opinion, questioning why we must rush to change these policies. “The recurrent creation of rights so unmoored from constitutional text or history will deplete the store of public respect on which a branch devoid of sword or purse must ultimately rely.” And the North Carolina State Treasurer referred to this decision as “unabashed judicial activism.”

But the West Virginia attorney who is representing his state, Attorney General Patrick Morrisey, plans on appealing to the Supreme Court. “Just one single sex-transition surgery can cost tens of thousands of dollars — taxpayers should not be required to pay for these surgeries under Medicaid. Our state should have the ability to determine how to spend our resources to care for the vital medical needs of our citizens.”

This ruling comes not long after England limited the ability of people younger than 16 from getting a medical gender transition, citing the lack of evidence about its long-term effects. England has since halted prescribing puberty blockers as a “routine treatment” for children with gender dysphoria. But the United States is less reasonable than England in this regard and insists on continuing down the mad, ideological path.

Sadly, this is not the only time that West Virginia has faced an immoral ruling from this appellate court. A few weeks ago, the same court ruled that the state’s restriction that women’s and girls’ sports are limited to biological women and girls was discriminatory.

It is a sad thing when society deems gender ideology more important than letting children compete fairly against their own gender and feel safe doing so. But that’s exactly what happened in West Virginia. A 13-year-old boy who identifies as a girl wanted to compete in cross-country running and track against biological girls. He had been barred from doing so, until the appellate court’s decision to overturn West Virginia’s law. So, he competed, and of course, he won the competition.

Meanwhile, at least five girls refused to compete against him at all and watched as he robbed the victory from them and their peers.

Former competitive swimmer Riley Gaines tweeted, “It’s a sad day when 13-14yr old girls have to be the adults in the room, but I couldn’t be more inspired by and proud of these girls. Enough is enough. The tide is turning!” Let’s pray that Riley is right and that our nation turns back from the madness that is gender ideology.

Marisa Cantu has an MS in political science and international affairs with a BA in political science and has also studied international studies and French. She has a strong background in nonprofit work, research, writing, and policy proposal and analysis.

In her free time, Marisa enjoys painting, writing, cooking, spending time with her husband and playing with her dog.

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