Why is NC’s treasurer still trying to pick on the state’s transgender employees? | Opinion

For four years, trans employees of the state have been fighting North Carolina Treasurer Dale Folwell in court to get access to care that would make their lives easier. Last week, a three-judge U.S. Court of Appeals panel heard arguments from the state’s legal team?, which argued that North Carolina’s employee healthcare policy does not discriminate against trans employees.

In 2019, multiple plaintiffs sued the state for not covering gender affirming care — namely hormone replacement therapy and reconstructive surgery. The state previously provided this care in 2017.

In the first ruling, the circuit court sided with the plaintiffs. In last week’s hearings, it appeared that the chief circuit judge agreed.

“Why pick on transgender dysphoria?” the Chief Circuit Judge Roger Gregory asked the lawyers. Gregory also told the state’s attorney, John Knepper, that the exclusions singled out trans people, who are a protected class.

Knepper, who is representing the state, insisted that “the plan is picking on everybody.”

North Carolina has a higher percentage of trans adults than any other state. The Williams Institute at UCLA found that North Carolina has around 71,300 trans adults, making it the fifth-largest adult trans population in the country. About 1.27% of the state’s youth ages 13-18 are transgender, meaning that of everyone in the state over 13, there are 80,000 people who could benefit from some form of treatment for gender dysphoria: less than 1% of the total population.

Of course, not all 80,000 trans people in North Carolina are insured under the state health care plan. A Folwell spokesperson says that the department does not track how many people would benefit, but if the 74,000 people employed by the state are representative of the general population, we’re talking about less than 600 trans people aged 13 and up who would benefit from state coverage.

Even among that estimate, not every trans person is seeking hormone replacement therapy or reconstructive surgery. The National Transgender Discrimination Survey found that 80% of trans people have tried or want to try hormone replacement therapy. Again, if this is the case for state employees, then less than 600 becomes fewer than 500.

It’s not clear how much money the state would save if 450 people or so are denied the care they need. It’s also unclear how much the state is spending to drag this case through the court system.

Those 450 people deserve a welcoming work environment and a health insurance plan that will cover their life-saving medical care. Gender-affirming care does more than boost the mental health of trans people — it also means that they look more like their gender to everyone else, which can protect them from transphobic violence.

Compare it to infertility treatments, which are covered in some of the state insurance plans. Infertility treatments aren’t the only way that a couple could have a child, since there’s always adoption (although that process isn’t easy, either). Infertility treatment can also be costly, and the state is not required by law to include it in health care plans.

For some women, however, carrying a pregnancy and giving birth are important parts of motherhood. For some trans people, receiving hormone treatment or reconstructive surgery are needed for them to feel that their bodies are theirs.

It’s not really clear why Folwell’s office insists on arguing this case. It’s possible that this is a political calculation as he considers a run for governor.. Might he be using fear and hatred of a marginalized group of people to gain political points with voters ahead of 2024?

What is clear, however, is that trans people are increasingly under attack from institutions that should protect everyone, but often fail to. The more politicians use policy to show that trans people shouldn’t be allowed to exist the way they want to, the more trans people are threatened by people who would rather they not exist at all.