Court revisits West Virginia’s Medicaid ban on transgender surgeries
A federal appeals court has revisited the dispute over West Virginia’s Medicaid policy on gender-affirming care. The state currently funds some treatments, like counselling and hormones, but excludes surgery for transgender adults. On December 9, 2025, judges heard arguments in Anderson v. Crouch, a case challenging this exclusion as discriminatory and unlawful.
The case centres on Shauntae Anderson, a transgender woman who began hormone therapy in 2019 after starting estrogen via birth control pills. West Virginia’s Medicaid programme covers her hormones and mental health support but denies coverage for gender-affirming surgery. Anderson’s legal team argues this exclusion violates the Equal Protection Clause, the Medicaid Act, and the Affordable Care Act by singling out transgender patients.
The Fourth Circuit’s decision will determine whether West Virginia must cover gender-affirming surgeries under Medicaid. A ruling in Anderson’s favour would reaffirm the 2024 precedent and require the state to fund these procedures. If upheld, the exclusion would remain, leaving transgender adults without surgical care under the programme.
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