ANALYSIS: Gender-Affirming Coverage Wins Backing Beyond Bostock

The US Supreme Court’s 2020 Bostock ruling was a win for champions of a more inclusive workplace, however its applicability beyond employment discrimination remains a subject of debate. A recent Fourth Circuit decision and a Department of Health and Human Services final rule interpreting the Affordable Care Act’s nondiscrimination provisions will offer more compelling support for plaintiffs challenging gender-affirming coverage bans.

Bostock held that gender identity and sexual orientation discrimination in employment amounts to sex discrimination under Title VII of the Civil Rights Act. Plaintiffs in cases challenging gender-affirming care coverage and other forms of gender identity discrimination have ...