In 2020, the U.S. Supreme Court ruled in Bostock v. Clayton County that gender identity and sexual orientation are protected characteristics included in the meaning of “sex” under Title VII of the 1964 Civil Rights Act. In the years since then, courts have clashed over Bostock’s application in cases involving access to gender-affirming health care.

The U.S. Court of Appeals for the Eleventh Circuit’s recent landmark ruling in Lange v. Houston County provides both clarity and hope on this issue. On May 13, 2024, a three-judge panel for the Eleventh Circuit ruled that employers cannot discriminate against transgender employees by categorically excluding coverage for gender-affirming care from employee health care plans. Such an exclusion discriminates on the basis of sex by singling out transgender employees for especially bad treatment—an act, the court concluded, Title VII does not tolerate.