Houston County and Sheriff’s Office held liable for discrimination against transgender woman 

HOUSTON COUNTY – The United States Court of Appeals found Houston County and the Houston County Sheriff liable for discrimination against Anna Lange, a transgender woman. 

According to the court opinion, Houston County provides a health insurance plan to its employees, as well as employees of the Houston County Sheriff’s Office via a decades-long intergovernmental arrangement between both entities, designated in the opinion as the Health Plan.

Lange was assigned a male at birth but knew of herself as a woman. In 2006, Lange began working at the Sheriff’s Office under Sheriff Cullen Talton. 

“Throughout most of her life, including her time employed at the Sheriff’s Office, she experienced gender dysphoria,” the opinion said. “Gender dysphoria is a condition that causes feelings of discomfort and distress because of the incongruence between one’s gender identity and their sex assigned at birth.” 

Lange was diagnosed with gender dysphoria by a healthcare provider in 2017. The following year, Lange told the Sheriff’s Office she was transgender and would be living her life as a woman from now on. 

“Lange’s healthcare provider started her on a treatment plan to align her physical characteristics with her gender identity,” the opinion said. “The plan comprised of hormone therapy and gender affirming surgery, both of which are shown to alleviate symptoms of gender dysphoria.” 

When Lange handed over her insurance provider to get the surgery, she was denied based on the Health Plan’s exclusion of “drugs for a sex change surgery” and “services and supplies for a sex change and/or the reversal of a sex change”. 

Lange then appealed with her healthcare provider Anthem, but they denied her appeal. 

She also brought up her situation to the Houston County Commissioners requesting that exclusion be removed, but to no avail. After this, Lange filed claims against Houston County with help from the Equal Employment Commission along with suing Houston County and the Sheriff in the Middle District of Georgia. 

“In addition to seeking relief under Title VII, Lange sought relief under Title I of the Americans Disabilities Act and the Equal Protection Clause of the United States Constitution,” the opinion said. “In granting summary judgment to Lange on the Title VII claim, the district court found the Exclusion facially discriminatory as a matter of law. The Title VII claim then proceeded to trial, and a jury awarded Lange $60,000 in damages.” 

“Defendants argue that the district court erred in holding that: (1) the Exclusion violates Title VII; and (2) Houston County is liable under Title VII as an agent of the Sheriff’s Office. Defendants also assert that the district court abused its discretion in granting a permanent injunction,” the opinion said. 

“We conclude that the district court was correct in finding that the Exclusion violated Title VII. There is no genuine dispute of fact or law as to whether the Exclusion unlawfully discriminates against Lange and other transgender persons. The Exclusion is a blanket denial of coverage for gender-affirming surgery.”

“The district court found that Houston County had not considered ‘any cost information prior to deciding not to consider Lange’s request to remove the Exclusion.’ The district court consequently did not err in holding Houston County liable under Title VII. The administration and provision of health insurance was delegated from the Sheriff’s Office to Houston County,” the opinion said. 

“In granting a permanent injunction, the dis-trict court may grant relief if the plaintiff has shown that:

(1) [the plaintiff] has suffered an irreparable injury;

(2) remedies available at law, such as monetary dam-

ages, are inadequate to compensate for that injury;

(3) considering the balance of hardships between the plaintiff and defendant, a remedy in equity is warranted 

(4) the public interest would not be disserved by a permanent injunction,” the opinion said. 

“After reviewing the briefs, and having the benefit of oral argument, we find that Defendants have failed to show that the district court abused its discretion in entering a permanent injunction. The record supports finding that Lange met most, if not all, of the criteria outlined above.”

“For these reasons, we affirm the district’s well-reasoned opinion finding Houston County and the Sheriff of Houston County liable under Title VII, and we affirm the district court’s subsequent order enjoining further enforcement or application of the Exclusion,” the opinion said.