Federal lawsuit challenges Tennessee ban on insurance coverage for state employees’ transgender treatments

Staff file photo / A University of Tennessee at Chattanooga sign near an entrance to the campus along McCallie Avenue is shown.

NASHVILLE — Two transgender women, one of them a University of Tennessee at Chattanooga employee, filed a lawsuit Thursday in U.S. District Court in Nashville charging they were denied "essential medical coverage" for transgender medical procedures through the state's health plan.

Gerda Zinner, a 30-year-old transgender woman from Hamilton County who has worked at UTC since 2019 and is an academic advisor, and Story VanNess, 38, a transgender woman who lives in Knox County and worked five years as a special education teacher for Knox County Schools, say in the suit they were denied care through state or local health plans.

"It took years of careful consideration before I was finally in a position to move forward with surgical care, an important part of my transition," Zinner said in a news release. "Knowing that the only reason I can't get the care that my doctors and I have decided that I need is because I'm transgender is hurtful and makes me feel second class."

VanNess said working with students who have special needs was one of the greatest joys of her life, but it was "excruciating" to be denied coverage for needed health care simply because she is transgender.

The suit alleges when Story sought to have transition-related surgery after consultation with her doctor, her therapist and two surgeons, she was denied coverage because the state's program excludes medically necessary procedures for transgender people seeking transition-related care.


The 50-page suit says both plaintiffs require medically-necessary treatment for gender dysphoria, described as the "clinically significant distress" that can result from the "dissonance" between a transgender individual's gender identity and sex assigned at birth.

"This is a case about discrimination in employment, health care and education," the lawsuit says. "Tennessee's public employee health benefits program has unlawfully deprived plaintiffs of coverage for essential medical services because of the plaintiffs' sex and because they are transgender. The defendants continue to carry out their discriminatory practices. Plaintiffs therefore bring this lawsuit for declaratory, compensatory and equitable relief."

Defendants in the suit include the state of Tennessee, the State Insurance Committee and individual members of the panel in their official capacities.

Other defendants listed in the suit include state Finance Commissioner Jim Bryson as well as University of Tennessee System President Randy Boyd. Also included as defendants are Senate Finance Committee Chairman Bo Watson, R-Hixson, and House Finance Chairwoman Patsy Hazlewood, R-Signal Mountain, because of their roles as members of the State Insurance Committee. Neither lawmaker responded to Chattanooga Times Free Press inquiries about the lawsuit.

The litigation was filed by the Transgender Legal Defense & Education Fund, Washington, D.C.-based Covington & Burling LLC and Nashville-based law firms Sherrard Roe Voigt Harbison and Sperling & Slater.

"The only reason the state of Tennessee refuses to provide these women with coverage for medically necessary health care is because they are transgender," Ezra Cukor, staff attorney with the Transgender Legal Defense & Education Fund, said in the release. "This is clearly unlawful discrimination that jeopardizes the health of hardworking state employees and their families."

Gov. Bill Lee's press secretary, Jade Beyers, said by email the administration "can't comment on pending litigation."

Elizabeth Lane, spokeswoman for Tennessee Attorney General Jonathan Skrmetti, offered this in an email: "We are reviewing the lawsuit and look forward to vigorously defending the state."

Zinner and VanNess' attorneys argue in the suit that Tennessee officials are violating the Equal Protection Clause of the U.S. Constitution, Title IX of the Education Amendments of 1972 and Title VII of the Civil Rights Act of 1964, by unlawfully discriminating based on sex and transgender status.

"All mainstream medical associations, including the American Medical Association and the American Psychological Association, recognize that transition-related care can be medically necessary and life-saving. The AMA and other medical organizations have called for an end to discriminatory exclusions of transition-related medical care from public and private health insurance policies," the suit says.

Federal laws protect transgender people from workplace discrimination on the basis of sex, Darren Teshima, a partner at Covington & Burling, said in the release.

"This lawsuit seeks to ensure that the state of Tennessee and its affiliates stop wrongfully excluding medically necessary transition-related care from their employee health care plans. Covington is very proud to partner with our co-counsel and clients in this important work," Teshima said.

Earlier this year, Lee signed into law several bills targeting the transgender community that were passed by fellow Republicans in the General Assembly. They included a ban on medical procedures for transgender children, prohibiting the use of puberty blockers and hormone treatments to treat underlying dysphoria. It also bans most surgeries, which are rare, for minors.

Another law passed by GOP lawmakers and signed by Lee dealt with drag shows and clamped down on attendance by children.

Contact Andy Sher at asher@timesfreepress.com or 615-285-9480.