On Monday, the nation’s largest LGBTQ+ legal group sued an insurance company for denying care to a transgender kid, a case that could potentially restore nondiscrimination protections axed by the Trump administration.  

Lambda Legal is taking Blue Cross Blue Shield of Illinois to court for refusing to cover transition-related care that a 15-year-old boy’s doctors, parents and mental health providers say he needs. According to the complaint, Blue Cross excludes coverage for “gender-affirming health care, including surgical care.” For Patricia and Nolle Pritchard, that means they have had to take out a loan to pay the $10,000 needed for their son’s health care, they said. 

The boy, identified only as C.P. has lived as male since 2015, though he showed signs of wanting to transition much younger, his parents said. 

“The shorter the hair, the happier C.P. got. He would want to be called a male name, and it was kind of a play on his name at the time and so we went along with it, but we just didn’t quite get the full [picture],” said Nolle Pritchard. 

Today, C.P.’s birth certificate, social security identification, and passport all reflect that he is male. 

“I am a boy,” C.P. told The 19th. “Just having this medical stuff, it helps me feel better.”

C.P., who has a medical diagnosis of gender dysphoria, has been working with doctors and therapists for more than three years. In 2016, they determined that C.P. needed puberty blockers, a temporary reversible implant that allows trans youth to pause puberty until they are old enough to decide if they want to medically transition. The treatment has been shown to lower the risk of suicidal thoughts in trans people by 15 percent, according to a recent study published in the journal Pediatrics. 

Blue Cross declined to cover the procedure, however, and the family paid out-of-pocket, the suit says. In 2019, C.P. underwent a masculinizing top surgery at the advice of his doctors. The insurance company didn’t foot the bill for that either. 

“It was important to our family not to allow any gaps or delay and care for C.P. for his affirming care,” said Patricia Pritchard. 

Blue Cross Blue Shield of Illinois did not respond to a request to comment by press time.

Lambda Legal’s Omar Gonzalez-Pagan accuses Blue Cross of trying to skirt the bill by defaulting to a policy preferred by Patricia Pritchard’s employer, who provides her with benefits. She receives coverage through Catholic Health Initiatives Medical Plan. 

“This case is clearly meant to clearly establish that health insurance companies and health benefit administrators like Blue Cross Blue Shield cannot simply administer plans with discriminatory terms, no matter their provenance, whether it’s their own or somebody else’s,” Gonzalez-Pagan said.

A win could be a landmark decision for transgender health care. The case argues that the Affordable Care Act’s 1557 provision covers transgender people. Until June, the 1557 statute included a clause protecting against discrimination on the basis of gender identity, explicitly protecting transgender Americans. The Trump administration rolled back those protections. Monday’s case, however, argues that sex discrimination protections in the law also cover trans people.

Lambda Legal may likely prevail on that point. In June, the Supreme Court ruled that sex discrimination protections in the Civil Rights Act of 1964 applied to LGBTQ+ workers. Legal scholars say it could only be a matter of time before that precedent upends anti-LGBTQ+ policy in courts across the nation. 

LGBTQ+ groups are eager to make those cases. Out2Enroll, a group of nonprofits that aims to educate LGBTQ+ people about the ACA, reported that while the number of insurance carriers explicitly covering trans-related care skyrocketed under the Trump administration from 17 percent to 47 percent, those banning such care in the last year more than doubled. Before the Trump administration rolled back protections, only 3 percent of insurers barred trans care; now 7 percent have trans exclusions.