Whether West Virginia violated the Equal Protection Clause by declining to cover surgical treatments for gender dysphoria

QUESTIONS PRESENTED Based on concerns like cost and effectiveness, West Virginia Medicaid excluded coverage for certain surgeries that treat gender dysphoria. It continued to cover other kinds of gender-dysphoria treatments. West Virginia never asked whether a patient was transgender in making any coverage decisions. A group of Medicaid beneficiaries brought a classaction suit challenging the surgery exclusion. A divided 86 en bane Fourth Circuit ultimately decided that West Virginia’s surgical exclusion violated the Equal Protection Clause, the Medicaid Act, and the Affordable Care Act’s non-discrimination provision. West Virginia Medicaid must now pay for surgical treatments for gender dysphoria. The questions presented are: 1. Whether West Virginia violated the Equal Protection Clause by declining to cover surgical treatments for gender dysphoria; and 2. Whether West Virginia violated the Medicaid Act and the Affordable Care Act by declining to cover surgical treatments for gender dysphoria.