Federal Government
4th Circuit rules gender identity is a protected characteristic
Ruling a response to N.C., W.Va. legal challenges
BY ERIN REED | The 4th U.S. Circuit Court of Appeals ruled Monday that transgender people are a protected class and that Medicaid bans on trans care are unconstitutional.
Furthermore, the court ruled that discriminating based on a diagnosis of gender dysphoria is discrimination based on gender identity and sex. The ruling is in response to lower court challenges against state laws and policies in North Carolina and West Virginia that prevent trans people on state plans or Medicaid from obtaining coverage for gender-affirming care; those lower courts found such exclusions unconstitutional.
In issuing the final ruling, the 4th Circuit declared that trans exclusions were “obviously discriminatory” and were “in violation of the equal protection clause” of the Constitution, upholding lower court rulings that barred the discriminatory exclusions.
The 4th Circuit ruling focused on two cases in states within its jurisdiction: North Carolina and West Virginia. In North Carolina, trans state employees who rely on the State Health Plan were unable to use it to obtain gender-affirming care for gender dysphoria diagnoses.
In West Virginia, a similar exclusion applied to those on the stateās Medicaid plan for surgeries related to a diagnosis of gender dysphoria. Both exclusions were overturned by lower courts, and both states appealed to the 4th Circuit.
Attorneys for the states had argued that the policies were not discriminatory because the exclusions for gender affirming care āapply to everyone, not just transgender people.ā The majority of the court, however, struck down such a claim, pointing to several other cases where such arguments break down, such as same-sex marriage bans āapplying to straight, gay, lesbian, and bisexual people equally,ā even though straight people would be entirely unaffected by such bans.
Other cases cited included literacy tests, a tax on wearing kippot for Jewish people, and interracial marriage in Loving v. Virginia.
See this portion of the court analysis here:

Of particular note in the majority opinion was a section on Geduldig v. Aiello that seemed laser-targeted toward an eventual U.S. Supreme Court decision on discriminatory policies targeting trans people. Geduldig v. Aiello, a 1974 ruling, determined that pregnancy discrimination is not inherently sex discrimination because it does not “classify on sex,” but rather, on pregnancy status.
Using similar arguments, the states claimed that gender affirming care exclusions did not classify or discriminate based on trans status or sex, but rather, on a diagnosis of gender dysphoria and treatments to alleviate that dysphoria.
The majority was unconvinced, ruling, āgender dysphoria is so intimately related to transgender status as to be virtually indistinguishable from it. The excluded treatments aim at addressing incongruity between sex assigned at birth and gender identity, the very heart of transgender status.ā In doing so, the majority cited several cases, many from after Geduldig was decided.
Notably, Geduldig was cited in both the 6th and 11th Circuit decisions upholding gender affirming care bans in a handful of states.
The court also pointed to the potentially ridiculous conclusions that strict readings of what counts as proxy discrimination could lead to, such as if legislators attempted to use āXX chromosomesā and āXY chromosomesā to get around sex discrimination policies:
Importantly, the court also rebutted recent arguments that Bostock applies only to “limited Title VII claims involving employers who fired” LGBTQ employees, and not to Title IX, which the Affordable Care Actās anti-discrimination mandate references. The majority stated that this is not the case, and that there is “nothing in Bostock to suggest the holding was that narrow.”
Ultimately, the court ruled that the exclusions on trans care violate the Equal Protection Clause of the Constitution. The court also ruled that the West Virginia Medicaid Program violates the Medicaid Act and the anti-discrimination provisions of the Affordable Care Act.
Additionally, the court upheld the dismissal of anti-trans expert testimony for lacking relevant expertise. West Virginia and North Carolina must end trans care exclusions in line with earlier district court decisions.
The decision will likely have nationwide impacts on court cases in other districts. The case had become a major battleground for trans rights, with dozens of states filing amicus briefs in favor or against the protection of the equal process rights of trans people.Ā Twenty-one Republican statesĀ filed an amicus brief in favor of denying trans people anti-discrimination protections in healthcare, and 17 Democratic statesĀ joined an amicus brief in support of the healthcare rights of trans individuals.
Many Republican states are defending anti-trans laws that discriminate against trans people by banning or limiting gender-affirming care. These laws could come under threat if the legal rationale used in this decision is adopted by other circuits. In the 4th Circuitās jurisdiction, West Virginia and North CarolinaĀ already have gender-affirming care bans for trans youth in place, andĀ South Carolina may consider a similar bill this week.
The decision could potentially be used as precedent to challenge all of those laws in the near future and to deter South Carolinaās bill from passing into law.
The decision is the latest in a web of legal battles concerning trans people. Earlier this month, the 4th Circuit also reversed a sports ban in West Virginia, ruling that Title IX protects trans student athletes. However, theĀ Supreme Court recently narrowedĀ a victory for trans healthcare from the 9th U.S. Circuit Court of Appeals and allowed Idaho to continue enforcing its ban on gender-affirming care for everyone except the two plaintiffs in the case.
Importantly, that decision was not about the constitutionality of gender-affirming care, but the limits of temporary injunctions in the early stages of a constitutional challenge to discriminatory state laws. It is likely that the Supreme Court will ultimately hear cases on this topic in the near future.
Celebrating the victory, Lambda Legal Counsel and Health Care Strategist Omar Gonzalez-Pagan said in a posted statement, āThe courtās decision sends a clear message that gender-affirming care is critical medical care for transgender people and that denying it is harmful and unlawful ⦠We hope this decision makes it clear to policy makers across the country that health care decisions belong to patients, their families, and their doctors, not to politicians.ā
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Erin Reed is a transgender woman (she/her pronouns) and researcher who tracks anti-LGBTQ+ legislation around the world and helps people become better advocates for their queer family, friends, colleagues, and community. Reed also is a social media consultant and public speaker.
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The preceding article was first published at Erin In The Morning and is republished with permission.
Federal Government
Markwayne Mullin confirmed as next DHS secretary
Okla. senator to succeed Kristi Noem
The U.S. Senate confirmed Markwayne Mullin as the next secretary of Homeland Security on Monday, as the agency continues to grapple with what lawmakers have described as a ānever-endingā funding standoff, with Democrats attempting to withhold funding from one of the nationās largest and most costly agencies.
Mullin ā a Republican senator from Oklahoma, former mixed martial arts fighter, and plumbing business owner ā was confirmed in a 54ā45 vote. Two Democrats ā U.S. Sens. John Fetterman (D-Pa.) and Martin Heinrich (D-N.M.) ā sided with Republicans in supporting his confirmation.
The new agency head is expected to follow the policy direction set by President Donald Trump, emphasizing stricter immigration enforcement. This includes proposals to support immigration agents at polling sites and to cut funding to so-called āsanctuary cities.ā
Mullin replaces Kristi Noem, who was fired earlier this month following a widely scrutinized 2-day congressional hearing on Capitol Hill.
During the hearing, Noem faced intense questioning over her response to several crises, including the fatal shooting of two American citizens in Minneapolis by U.S. Immigration and Customs Enforcement agents, a $220 million border security advertising campaign that featured her on horseback near Mount Rushmore amid one of the largest federal workforce reductions in U.S. history, and the federal response to major natural disasters such as the July 2025 Texas floods and Hurricane Helene in 2024.
Noem had previously drawn criticism for a series of policy decisions in South Dakota that broadly focused on restricting the rights of LGBTQ individuals. In 2023, she signed House Bill 1080, banning gender-affirming medical care for transgender minors. She also signed legislation and executive orders restricting trans athletesā participation in womenās sports, as well as the stateās āReligious Freedom Restoration Act,ā which critics argued enabled discrimination against LGBTQ individuals. Additionally, the state canceled contracts related to LGBTQ support services ā including suicide prevention and health care navigation programsā and later agreed to a $300,000 settlement with trans advocacy group, The Transformation Project.
Despite her removal from DHS, Noem will remain in the Trump-Vance administration as a special envoy for the āShield of the Americas,ā an initiative aimed at promoting U.S. influence in the Western Hemisphere, including efforts to counter cartel networks, reduce Chinese influence, and manage migration.
The new head of DHS has served in Congress since 2013, in both houses of the federal legislature. While in the Senate and a member of the Health, Education, Labor, and Pensions (HELP) Committee, Mullin has been a vocal critic of policies aimed at expanding LGBTQ inclusion. He led a group of lawmakers in urging the Administration for Community Living to reverse a rule requiring states to prioritize Older Americans Act services based on sexual orientation and gender identity, arguing the policy could have unintended consequences.
Mullin also makes history as the first Native American ā and a citizen of the Cherokee Nation ā to lead the Department of Homeland Security. He was also among the 147 Republicans who voted to overturn the 2020 presidential election results despite no evidence of widespread fraud, and was present in the U.S. House of Representatives chamber on Jan. 6.
Federal Government
Protesters say SAVE Act targets voters, transgender youth
Bill described as āJim Crow 2.0ā
Members of Congress, advocates, and people from across the country gathered outside the U.S. Capitol on Tuesday to protest proposed federal legislation that voting rights activists have deemed āJim Crow 2.0.ā
The Safeguard American Voter Eligibility (SAVE) Act would amend the National Voter Registration Act of 1993 to require in-person proof of citizenship for anyone seeking to vote in U.S. elections.
President Donald Trump has also pushed for the proposed legislation to include a section that would ban gender-affirming medical care for transgender minors, even with parental consent, and prohibit trans people from participating in school or professional sports consistent with their gender identity rather than their sex assigned at birth.
In addition to changing voter registration requirements, the bill would limit acceptable forms of identification to documents such as a birth certificate or passport ā records that the Brennan Center for Justice estimates more than 21 million Americans do not have ā effectively restricting access to the ballot. It would also ban online voter registration, DMV voter registration efforts, and mail-in voter registration.
A 2021 investigation by the Associated Press found that fewer than 475 people voted illegally or improperly, a tiny fraction of the estimated 160 million Americans who voted in the 2020 election.
Senate Minority Leader Chuck Schumer (D-N.Y.) spoke at the event.
āIt will kick millions of American citizens off the rolls. And they don’t even require you to be told,ā the highest-ranking Democrat in the Senate told protesters and reporters outside the Capitol. āIf this law passes ā and it won’t ā you’re gonna show up in November … and they’ll say⦠sorry, you’re no longer on the voting rolls.ā

He, like many other speakers, emphasized the bill in the context of American history, pointing to what he described as its racist roots and its impact on Black and brown Americans.
āI have called this act, over and over again, Jim Crow 2.0 … because they know it’s the truth.ā
U.S. Sen. Alex Padilla (D-Calif.) was one of the lawmakers leading opposition to the legislation and spoke at the rally.
āIt’s not just voting rights that are on the line ā our democracy is on the line,ā the California lawmaker said. āIt’s not a voter I.D. bill. It’s a bait and switch bill.ā
He added historical context, noting the significance of voting rights legislation passed more than 60 years ago. In 1965, Alabama civil rights activists marched to protest barriers to voter registration. Alabama state troopers violently attacked peaceful demonstrators at the Edmund Pettus Bridge in Selma, using tear gas, clubs, and whips against more than 500 ā mostly Black ā protesters.

ā61 years ago ā not to the day ā but this week, President Lyndon Johnson came to the Capitol and addressed a joint session of Congress in the wake of Bloody Sunday and pushed Congress to pass the Voting Rights Act,ā Padilla said. ā61 years later, Donald Trump and this Republican majority wants to take us backwards. We’re not gonna let that happen.ā
U.S. Sen. Ben Ray LujƔn (D-N.M.) also spoke, emphasizing that he views the effort as a Republican-led and Trump-backed attempt to restrict voting access, particularly among Black, brown, and predominantly Democratic communities.
āPresident Trump told Republicans when they were meeting behind closed doors that āThe SAVE Act will guarantee Republicans win the midterms and ensure they do not lose an election for 50 years,āā LujĆ”n said. āThe first time I think Donald Trump’s been honest … This voter suppression bill is only that. Taking away vote by mail? I hope my Republican colleagues from states that voted for Donald Trump or where vote by mail is popular have the courage and the backbone to stand up and say no to this nonsense, because their constituents are going to push back.ā
U.S. Sen. Lisa Blunt Rochester (D-Del.) also spoke.
āOur Republican colleagues have already cut Medicaid, Medicare, people don’t know how they’re gonna be able to afford energy,ā she said, providing context for the broader political moment. āWe’re in the middle of a war that they can’t even get straight while we’re in it and don’t have a way to get out of it. And we are now faced with defending our democracy?ā
She then showed the crowd something that she said has been with her throughout her political journey in Washington.
āI brought with me something that I carried on the day that I was sworn into the House of Representatives when I was elected in 2016, and I carried it with me on the day that I was sworn in as United States senator. And I also carried it with me when I was trapped up in the gallery on Jan. 6 and all I could think to do was pray … This document allowed my great great great grandfather, who had been enslaved in Georgia, to have the right to vote. We took this and turned it into a scarf. It is the returns of qualified voters and reconstruction code from 1867. This is my proof of what we’ve been through. This is also our inspiration.ā

āI got to travel between the Edmund Pettus Bridge two times. And even as I thought about this moment, I recognized that while we wish we weren’t in it, while we don’t know why we’re in it, I do know we were made for it … So I came today to tell you that, um, just like the leader said, that he calls it Jim Crow 2.0. I call it Jim Crow 2.NO.ā
Kelley Robinson, president of the Human Rights Campaign, the largest LGBTQ advocacy organization in the U.S., also spoke, highlighting the impact of the billās proposed provisions affecting trans people.
āThis bill is not about saving America. This bill is about stealing an election. This bill is about suppressing voters,ā Robinson said. āThis bill not only tries to disenfranchise voters that deserve their right to vote, it also tries to criminalize trans kids and their families … It tries to criminalize doctors providing medically necessary care for our trans youth.ā

The SAVE Act passed the U.S. House of Representatives on Feb. 11 but has not yet been considered in the U.S. Senate.
Federal Government
Gay Venezuelan man āforcibly disappearedā to El Salvador files claim against White House
Andry HernƔndez Romero had asked for asylum in US
A gay Venezuelan asylum seeker who the U.S. āforcibly disappearedā to El Salvador has filed a claim against the federal government.
Immigrant Defenders Law Center, who represents Andry HernĆ”ndez Romero, on Friday announced their client and five other Venezuelans who the Trump-Vance administration āforcibly removedā to El Salvador under the Alien Enemies Act of 1798, filed āadministrative claimsā under the Federal Tort Claims Act.
The White House on Feb. 20, 2025, designated Tren de Aragua, a Venezuelan gang, as an āinternational terrorist organization.ā
President Donald Trump less than a month later invoked the Alien Enemies Act of 1798, which the Associated Press notes allows the U.S. to deport ānoncitizens without any legal recourse.ā The White House then āforcibly removedā HernĆ”ndez, who had been pursuing his asylum case in the U.S., and more than 250 other Venezuelans to El Salvador.
Immigrant Defenders Law Center disputed claims that HernƔndez is a Tren de Aragua member.
HernĆ”ndez was held at El Salvadorās Terrorism Confinement Center, a maximum-security prison known by the Spanish acronym CECOT, until his release on July 18, 2025. HernĆ”ndez, who is back in Venezuela, claims he suffered physical and sexual abuse while at CECOT.
āAs a Venezuelan citizen with no criminal record anywhere in the world, I would like to tell not only the government of the United States but governments everywhere that no human being is illegal,ā said HernĆ”ndez in the Immigrant Defenders Law Center press release.Ā āTheĀ practice of judging whole communitiesĀ forĀ the wrongdoing of a single individualĀ must end. GovernmentsĀ should use theirĀ powerĀ toĀ help every person in the nation become more aware and informed,Ā toĀ strengthen ourĀ culturesĀ and build a stronger generation with principles and valuesĀ āĀ one that multipliesĀ theĀ positive instead of destroyingĀ unfulfilled dreams andĀ opportunities.āĀ
Immigrant Defenders Law Center filed claims on behalf of HernƔndez and the five other Venezuelans less than three months after American forces seized then-Venezuelan President NicolƔs Maduro and his wife, Cilia Flores, at their home in Caracas, the Venezuelan capital.
Maduro and Flores have pleaded not guilty to federal drug charges. Delcy RodrĆguez, who was Maduroās vice president, is Venezuelaās acting president.
āDue process and accountability cannot be optionalā
Immigrant Defenders Law Center on Friday also made the following demands:
- The Trump administration must officially release the names of all people the United States sent to CECOT to ensure that everyone has been or will be released.
- The federal government must clear the names of the 252 men wrongfully labeled as criminal gang members of Tren de Aragua.
- DHS (Department of Homeland Security) must end the practice of outsourcing torture through thirdācountry removals, restore humanitarian parole, and rebuild a functioning, humane asylum system.
- DHS must reinstate Temporary Protected Status for all individuals who cannot safely return to their home countries, halt mass deportations and unlawful raids and arrests, and guarantee due process for everyone navigating the immigration system.
- Congress must pass the Neighbors Not Enemies Act, which would repeal the Alien Enemies Act.
āIn all my years as an immigration attorney, I have never seen a client simply vanish in the middle of their case with no explanation,ā said Immigration Defenders Legal Fund Legal Services Director Melissa Shepard. āIn court, the government couldnāt even explain where he was ā he had been disappeared.ā
āWhen the government detains and transfers people in secrecy, without transparency or access to the courts, it tears at the basic protections a democracy is supposed to guarantee,ā added Shepard. āWhat this experience makes painfully clear is that due process and accountability cannot be optional. They are the only safeguards standing between people and the kind of lawlessness our clients suffered. We must end third country transfers, restore the asylum system, and humanitarian parole, and reinstate temporary protective status so this nightmare never happens again.ā
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