A Georgia employee requested their county include gender-affirming care as part of their health coverage. Instead, the county spent $1.2 million fighting the effort: report.

A Georgia employee requested their county include gender-affirming care as part of their health coverage. Instead, the county spent $1.2 million fighting the effort: report.
Protesters lay on the ground holding cardboard signs shaped like tombstones in front of the Marriott Fort Lauderdale Airport as the Florida Board of Medicine met inside on Aug 5, 2022.Jose A. Iglesias/El Nuevo Herald/Tribune News Service via Getty Images
  • A Georgia county was accused of refusing to include gender-affirming care as part of their health coverage.
  • An employee sued them for discrimination in 2019, ProPublica reported.

A Georgia county was accused of denying expanding their medical care coverage to include gender-affirming care for an employee and instead spent $1.2 million fighting the effort.

Sgt. Anna Lange, a sheriff's deputy in Georgia's Houston County requested her county expand its healthcare coverage to cover her gender-affirming care, according to court documents reviewed by Insider. The county refused, citing the cost as a primary reason, ProPublica reported.

Lange sued the county for discrimination, alleging that while the county provides necessary healthcare to employees, she was "being denied medically-necessary care under the plan because Houston County (the "County") has expressly and deliberately excluded the care she needs," per the court documents.

Houston County did not respond to Insider's request for comment at the time of publication.

Lange had worked for the Houston County Sheriff's Office for more than a decade before she came out as transgender to her co-workers in 2017 after a therapist diagnosed her with gender dysphoria. Her boss thought she was joking at first and later told her he didn't "believe in" being transgender, according to deposition notes obtained by ProPublica.


Soon, Lange realized that her county-issued health insurance would not cover much of the transitional care, and all her efforts to have it included were of no avail, ProPublica reported.

"You knew right then and there that no matter what I said, that it wouldn't matter," she told ProPublica. "It's a really helpless feeling."

Despite the concern over costs, ProPublica estimated that the legal fees to fight Lange's case were three times the county's budget for physical and mental health in a year.

After racking up medical debt with bills going to collectors and using up her savings and retirement funds, Lange told ProPublica she decided to sue the county in 2019 for employment discrimination. The county then hired a private law firm to fight against Lange in federal court, and paid them close to $1.2 million, ProPublica reported. ProPublica estimated the cost by adding the total direct payments to private law firms from the date the lawsuit was filed through Dec. 31, 2022.

"It was a slap in the face, really, to find out how much they had spent," Lange told ProPublica."They're treating it like a political issue, obviously, when it's a medical issue."


According to the Human Rights Campaign, including gender-affirming care as part of insurance plans especially for large companies usually only adds "a very small additional cost." One expert cited by ProPublica estimated that including transition-related care in the health plan would add just 0.1% to the cost of all claims.

However, Houston County claimed that even if the costs are minimal now, they'll eventually add up, and that including gender-affirming care on their health plans will make way for demands to include coverage for abortion or weight loss surgeries, ProPublica reported.

The Human Rights Campaign reported that the total cost for gender-affirming care for one person is estimated to be between $25,000 to $75,000, which is minimal compared to the cost of other procedures or drugs. Additionally, the Human Rights Campaign said that transgender people typically deal with other medical conditions as a result of not being able to transition.