LGBTQ+ feds sue to restore FEHB coverage of gender affirming care

A group of five federal employees filed a class action lawsuit against the Office of Personnel Management Monday, alleging that the agency’s cancellation of employer-sponsored health insurance coverage of gender affirming medical treatments amounts to unlawful sex discrimination.

When President Trump returned to office in January 2025, he signed an executive order requiring agencies to cease recognizing the concept of “gender identity” or the existence of transgender or otherwise gender non-conforming people. At OPM, implementation included instructing insurance carriers participating in the Federal Employees Health Benefits and Postal Service Health Benefits programs to cease covering gender-affirming care in most cases beginning last January.

The pseudonymous plaintiffs, four transgender or non-binary federal employees and one employee whose daughter is transgender, said they face medical bills in the tens of thousands of dollars if forced to pay out of pocket for the hormonal and surgical treatments their doctors have prescribed.

The lawsuit, filed in the U.S. District Court for Washington, D.C., alleges violations of Title VII of the 1964 Civil Rights Act, and describes the gender-affirming care ban as “akin to denying continuing insulin treatment for someone with diabetes.” And the treatments sought by transgender or gender non-conforming employees are still approved in other contexts for cisgender workers and beneficiaries.

“[OPM’s] carrier letters discriminate on the basis of sex on their face,” the lawsuit states. “[The first letter] excludes ‘chemical and surgical modification of an individual’s sex traits through medical interventions (to include “gender transition” services)’ from FEHB and PSHB coverage. This exclusion targets gender-affirming care—care that is sought by transgender and gender non-conforming people—and thereby singles out current and former employees for less favorable treatment and fewer employment benefits than accorded their non-transgender counterparts.”

Under 2024 Supreme Court precedent, discrimination on the basis of someone’s gender identity is unlawful under Title VII, though the executive order underlying this case itself advocates for Bostock v. Clayton County, Ga., to be overturned. Federal judges have blocked that edict’s implementation by a number of agencies, including the U.S. Bureau of Prisons in regard to its treatment of transgender inmates, though the agency violated that order last week.

Representing the plaintiffs are the Human Rights Campaign Foundation as well as former Merit Systems Protection Board Member Cathy Harris. Attorneys estimated that nearly 40,000 federal employees, retirees or dependents could be impacted by OPM’s gender affirming care ban.

“Healthcare access should never be weaponized to advance discrimination—and the denial of coverage for critical healthcare based simply on who you are blatantly violates the rights of all of us,” said HRCF President Kelley Robinson. “This odious policy is the latest example of the Trump administration’s obsession with targeting transgender people, using shameful and cruel tactics to threaten their employment, their health and the well-being of themselves and their families.”

“Federal employees have been through the wringer with the Trump administration,” Harris said. “We draw the line at blatant discrimination to deny healthcare to our nation’s dedicated civil servants.”

OPM did not respond to a request for comment.