A federal lawsuit has been filed alleging that Tennessee’s decision to exclude gender-affirming care for its employees is both unconstitutional and discriminatory. The lawsuit was brought forth by two individuals, Gerda Zinner (30) and Story VanNess (38), who were denied such services despite their medical teams deeming them medically necessary. While Zinner still works as an academic adviser for the state, VanNess had to leave her position as a special education teacher after an unsuccessful appeal.

The 50-page complaint, filed on Tuesday, asserts that Tennessee’s public employee health benefits program unlawfully denies coverage for essential medical services based on the plaintiffs’ sex and transgender identity. Zinner’s lawyers express that she feels her life is at a standstill due to unmet healthcare needs, while VanNess had to exhaust her savings to cover her treatments.

While Tennessee provides counseling and psychological treatment for gender dysphoria through a program serving approximately 290,000 teachers, state and local employees, lawmakers, and their dependents, it does not cover treatment related to sex transformations.

Similar policies are being challenged in other Republican-dominated states as well, some of which have implemented anti-transgender measures over the years. In a case in North Carolina, a trial court ruled that the state must pay for medically necessary services, including hormone therapy and certain surgeries, for transgender employees and their children. The state has appealed the decision to the 4th U.S. Circuit Court of Appeals, where it is combined with a similar case in West Virginia, awaiting a ruling.

State courts have also addressed the issue. In Montana, an administrative law judge awarded $66,500 in damages to a former county employee after ruling that the state’s denial of gender-affirming care constituted illegal sexual discrimination.

In recent years, Tennessee’s Republican-led legislature has increasingly enacted anti-transgender policies, such as banning doctors from providing gender-affirming care to minors, prohibiting transgender athletes from participating in girls’ sports, and protecting teachers from lawsuits if they refuse to use a transgender student’s preferred pronouns.

Earlier this year, Republican lawmakers introduced legislation that aimed to prevent the state from contracting with private companies covering gender-transitioning medical care, both within and outside the state, for Tennessee’s Medicaid program. However, the bill did not progress in the legislative session.

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