Court rules Georgia county didn't discriminate by denying coverage of gender-affirming surgery

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September 10th, 2025

A federal appeals court ruled that a Georgia county discriminated against a sheriff's deputy by failing to pay for gender-affirming surgery.
Anna Lange, a sheriff's sergeant in Houston County, Ga., poses for a picture, Nov. 14, 2023. A federal appeals court has upheld a lower court’s ruling that a Georgia county illegally discriminated against the sheriff’s deputy by failing to pay for her gender-affirming surgery. In its ruling Monday, May 13, 2024 the 11th U.S. Circuit Court of Appeals said it was tasked with determining whether a health insurance provider can be held liable under the Civil Rights Act of 1964 for denying coverage for a procedure because an employee is transgender. (AP Photo/Jeff Amy, file)

A federal appeals court has reversed previous court rulings that found a Georgia county illegally discriminated against a sheriff’s deputy by failing to pay for her gender-affirming surgery.

In its ruling Tuesday, the 11th U.S. Circuit Court of Appeals found in an 8-5 decision that Houston County’s policy of denying coverage did not violate the civil rights of sheriff’s Sgt. Anna Lange.

The decision of the full Atlanta-based appeals court overturned a three-judge appeals panel and a lower-court ruling that both found the refusal to cover Lange’s prescribed gender-affirmation surgery amounted to illegal sex discrimination under the Civil Rights Act of 1964.

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