Prescribing Based on Sex: Title VII and the Exclusion of Gender-Affirming Care in Lange v. Houston
This Article explores Lange v. Houston County, an Eleventh Circuit case with significant implications for Title VII’s prohibition against sex-based discrimination and for the accessibility of gender-affirming healthcare. Central to the case are two pivotal issues: whether Title VII’s protection against discrimination “because of sex” extends to transgender individuals, and whether employers can lawfully exclude coverage for medically necessary “sex change” surgeries. By analyzing relevant Supreme Court precedent and critically examining the parties’ arguments, this Article concludes that excluding gender-affirming treatment solely because it is sought for transition purposes constitutes unlawful sex discrimination under Title VII.