Five federal employees have filed a proposed class action against the Trump administration, challenging a policy that removes insurance coverage for gender-affirming healthcare from plans serving federal workers, retirees, Postal Service employees and their families.
The lawsuit was filed in the US District Court for the District of Columbia on Monday, 3 August. Known as Doe v Kupor, the case argues that the Office of Personnel Management’s policy discriminates against transgender employees in breach of Title VII of the Civil Rights Act of 1964, which prohibits workplace discrimination based on sex.
The five plaintiffs are proceeding anonymously and are seeking to represent other federal employees and family members affected by the exclusions.
Their complaint alleges that government health plans continue to cover medications, hormones and surgical procedures when prescribed for other medical reasons, but deny coverage when those same treatments form part of gender-affirming care.
Under the policy, treatments including hormone therapy, hysterectomies and facial surgery may be excluded when provided for gender transition, despite potentially being covered in other clinical circumstances. The lawsuit argues that this distinction unlawfully targets transgender and gender-nonconforming people.
Workers report cancelled care and soaring costs
The plaintiffs say the exclusions have resulted in rejected insurance claims, disrupted treatment and serious financial pressure.
One transgender State Department employee, who has received hormone therapy since 2018, alleges that he now faces more than US$100,000 in personal costs after his insurance stopped covering medically necessary gender-affirming surgery.
Another transgender State Department employee says coverage has been denied for routine hormone therapy, blood testing and follow-up appointments.
A Postal Service worker involved in the case says his family may be forced to use its savings to continue paying for treatment required by his transgender daughter. Other workers have reportedly delayed or abandoned care because they cannot afford to pay for it without insurance.
The lawsuit also challenges an exception intended to provide temporary coverage for patients already considered to be “mid-treatment”.
The plaintiffs argue that the government has failed to clearly explain which treatments or patients qualify, leaving insurers, healthcare providers and families uncertain about what will be covered.
That exception is expected to be removed from the beginning of the 2027 plan year, further limiting coverage for people already receiving treatment.
Tens of thousands could be affected
The Human Rights Campaign Foundation and employment law firm Correia & Puth are supporting the lawsuit.
The case seeks to restore insurance coverage for transgender federal workers, retirees and dependants whose access to care has been affected by the policy.
Research published by the Williams Institute at the UCLA School of Law estimates that at least 39,400 transgender people are covered by the Federal Employee Health Benefits programme.
Its estimates range from 39,400 to 57,800 transgender enrollees, including current employees, retirees and their dependants. The wider programme provides insurance coverage to approximately 8.3 million people.
The insurance restrictions followed guidance issued by the Office of Personnel Management in 2025. An initial directive addressed gender-affirming care for young people before a later letter expanded the exclusion to enrollees of all ages for the 2026 plan year.
Human Rights Campaign Foundation president Kelley Robinson said the organisation was prepared to contest the administration’s policy in federal court.
“Our message to the Trump administration is simple: ‘We’ll see you in court’,” Robinson said in a 3 August statement.
The administration had not publicly responded to the lawsuit when it was filed. The case will now proceed through the federal court system, where the plaintiffs are asking for the healthcare exclusions to be declared discriminatory and unlawful.
