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4th Circuit Upholds West Virginia Ban on Medicaid-Funded Gender-Affirming Surgeries for Adults

The unanimous ruling creates the first appellate validation of such restrictions, potentially influencing pending challenges.

Overview

  • A three-judge panel of the 4th U.S. Circuit on March 10 unanimously upheld West Virginia’s prohibition on Medicaid coverage for gender-affirming surgeries for adults.
  • The Republican-appointed judges reversed the court’s 2024 ruling after the Supreme Court directed reconsideration following its Tennessee decision on care for minors.
  • The panel reasoned the law targets procedures rather than people and described the surgeries as “experimental” and “dangerous.”
  • Reuters reported this is the first federal appeals court decision to uphold a restriction on healthcare coverage for transgender adults.
  • Major U.S. medical organizations support gender-affirming care as safe and effective, critics condemned the ruling, and a similar North Carolina case is now before the court.