US court upholds ‘horrifying’ state ban on adult trans healthcare

A federal court has allowed a US state to ban healthcare for trans adults in a concerning legal precedent for healthcare across the country.

The US 4th Circuit Court of Appeals upheld West Virginia’s ban on Medicaid coverage for gender-affirming surgeries in a unanimous ruling on Tuesday (10 March).

Republican-appointed judges reversed a ruling which blocked the ban, arguing with little evidence that gender-affirming care for trans adults was “dangerous,” urging states not to fund what it spuriously described as “experimental procedures.”

It further claimed that trans people had become “disdainful of their sex” and claimed, again without evidence, that banning such provisions would “encourage citizens to appreciate their sex.”

The three-judge panel’s ruling is the first time a federal court in the North American country to uphold a restriction on healthcare for trans adults, according to Reuters.

It has caused immense concern for trans Americans, several of whom saying the ruling is not only “horrifying” but completely contradicts the evidence on the effectiveness of gender-affirming care.

Every single major medical organisation in the US support the use of gender-affirming care to help support trans adults. Numerous studies have similarly proven gender-affirming treatments are safe and effective.

In a post on social media, human genomics academic Dr Jey McCreight branded the ruling “complete nonsense scientifically,” saying it was based on “fascist eugenics, not biology.”

The Full 4th Circuit had originally struck down the law in 2024, but was called upon by the Supreme Court to reconsider the case following its ruling on Tennessee’s law banning trans healthcare for under-18s. Judges will also consider a similar law from North Carolina.

It comes as US president Donald Trump, who appointed many of the judges responsible for the latest decision, continues to target medical institutions lawfully providing gender-affirming care in states where it remains legal.

Hospitals in Washington DC, California, and many other states have cited pressures from the Trump administration in decisions to shutter their gender-affirming care programmes for under-18s.

The wave of transphobic actions by the government prompted several genocide scholars to argue the country is in the early stages of a “mass atrocity” against the population.

Multiple scholars, including two former presidents of the International Association of Genocide Scholars (IAGS), claimed in an interview that the country could see future policies that would make the lives of trans people “intolerable.”

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