Tennessee's transgender care exclusions are discriminatory, a federal lawsuit alleges

NASHVILLE, Tenn. (AP) — Tennessee's decision to exclude gender-affirming care for its employees is unconstitutional and discriminatory, according to a federal lawsuit brought by two people who were denied such services while working for the state.

Attorneys representing Gerda Zinner, 30, and Story VanNess, 38, say the two were denied even though their medical teams deemed the services medically necessary. Zinner still works for the state as an academic adviser but VanNess has since left her position as a special education teacher after unsuccessfully appealing her case.

“Tennessee’s public employee health benefits program has unlawfully deprived plaintiffs of coverage for essential medical services because of the plaintiffs’ sex and because they are transgender,” stated the 50-page complaint filed Tuesday.

Zinner “feels that her life is on hold” because she now must live with “unmet healthcare needs,” her lawyers wrote. Meanwhile, VanNess' attorneys said she spent all her savings to pay for her treatments.

A program now in place in Tennessee — serving nearly 290,000 teachers, state and local employees, lawmakers and their dependents — provides counseling and psychological treatment for gender dysphoria but does not cover treatment “for, or related to, sex transformations."

Similar policies are in place — and being challenged — in other Republican-dominated states as well, some of which have advanced anti-transgender policies over the years. In North Carolina, a trial court ordered the state to pay for “medically necessary services,” including hormone therapy and some surgeries, for transgender employees and their children. State lawyers have appealed to the 4th U.S. Circuit Court of Appeals, which has combined the case with a similar fight in West Virginia. A ruling is still pending.

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

In recent years, Tennessee's Republican-led legislature has increasingly advanced anti-transgender policies, including banning doctors from providing gender-affirming care to minors, prohibiting transgender athletes from participating in girls’ sports and protecting teachers from lawsuits if they don’t use a transgender student’s preferred pronouns.

Republican lawmakers also introduced legislation earlier this year that would have prohibited the state from contracting with private companies that manage care for most of Tennessee’s Medicaid program if they cover gender-transitioning medical care, either inside or outside of the state. The bill did not advance in this year's session.