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A federal appellate court in Richmond became the first in the country to rule that state health-care plans must pay for gender-affirming surgeries, a major win for transgender rights amid a nationwide wave of anti-trans activism and legislation. The decision came from a set of cases out of North Carolina and West Virginia, where state officials argued that their policies were based on cost concerns rather than bias. The U.S. Court of Appeals for the 4th Circuit rejected that argument, saying the plans were discriminating against trans people in need of treatment. (Weiner, 4/29)

The U.S. Equal Employment Opportunity Commission (EEOC) updated the federal workplace guidelines after a quarter of a century to protect pronouns, bathrooms and abortion. The new guidance, released on Monday by the federal agency, fortified transgender employees’ rights such as being protected from misgendering and using the bathroom that matches their gender identity. Employees not complying with the guidelines are committing unlawful workplace harassment. (Timotija, 4/29)

Texas Gov. Greg Abbott (R) said Monday his state will not abide by the Biden administration’s sweeping new changes to Title IX, the federal civil rights law prohibiting sex-based discrimination at government-funded schools. In a letter to President Biden, Abbott railed against the revised rules — which provide new protections for transgender students — saying they’re “illegal” and the result of a “ham-handed effort to impose a leftist belief onto Title IX,” which Abbott said “exceeds your authority as President.” (Fortinsky, 4/29)

Rebecca and David Bell sat together in the front row, her hand on his knee. They burst into tears as they watched a legislative committee vote to begin ripping away essential therapy from their transgender daughter. They are among dozens, if not hundreds, of families in South Carolina that could be forced to leave the state to continue the care their children rely on as they transition. Their pleas and those of doctors have failed to stop legislation that barreled through the House of Representatives along party lines. It now is poised for debate on the Senate floor starting April 30 — days before the session ends. If passed, all treatment and therapy for transgender youth would be legally barred in South Carolina. (Corwin, 4/30)

�鶹Ů�� Health News: Sign Here? Financial Agreements May Leave Doctors In The Driver’s Seat

Cass Smith-Collins jumped through hoops to get the surgery that would match his chest to his gender. Living in Las Vegas and then 50, he finally felt safe enough to come out as a transgender man. He had his wife’s support and a doctor’s letter showing he had a long history of gender dysphoria, the psychological distress felt when one’s sex assigned at birth and gender identity don’t match. (Houghton, 4/30)