Sheriff’s deputy settles landmark transgender rights case against Georgia county

After winning a landmark transgender rights ruling that was later overturned, a sheriff’s deputy in central Georgia has settled an almost seven-year court battle challenging her employers’ health insurance plan.

Sgt. Anna Lange, a deputy in the Houston County Sheriff’s Office from 2006, has been locked in a court fight with the county and its sheriff since October 2019, after they refused to cover her gender-affirming surgery under the plan.

The litigation was going Lange’s way until September, when a divided federal appeals court ruled the county’s health insurance plan for employees is not inherently discriminatory, though it excludes coverage for gender-affirming surgery. That decision, which one dissenting judge described as a step back for basic human dignity, wiped out a landmark ruling previously issued in Lange’s favor.

Houston County sheriff's deputy Anna Lange (center) and her lawyers pose for a photograph outside the 11th Circuit Court of Appeals in Atlanta on Tuesday, Feb. 4, 2025. (Rosie Manins/AJC)

The case returned to the federal trial court in Macon for arguments about whether the plan was applied to Lange in a discriminatory way.

This week, Lange and her employers jointly ended the case and issued a public statement about their settlement, which includes a $5,000 reimbursement payment to Lange for claimed out-of-pocket expenses not covered by the health plan.

“To avoid the costs associated with further litigation, the parties decided to resolve the lawsuit,” they said in part.

Attorneys for the parties said they would not comment beyond the joint statement.

Lange, who got gender-affirming surgery under the plan after a trial court win in 2022, had previously criticized the sheriff and county for continuing the fight in the U.S. Court of Appeals for the 11th Circuit, saying her procedure cost “orders of magnitude less.”

U.S. District Judge Marc Treadwell held in 2022 that the plan’s exclusion of coverage for gender-affirming surgery violated the Civil Rights Act, and he barred the sheriff and county from enforcing or applying it.

Treadwell’s decision was upheld in 2024 by a three-judge panel of the 11th Circuit, which has jurisdiction in Georgia, Florida and Alabama. At the time, Lange’s attorneys said it was the first ruling from a federal appellate court concluding that it is unlawful for an employer to discriminate against transgender people in an employee healthcare plan.

Upon request by Houston County and its sheriff, the full 11th Circuit vacated the panel’s decision and reviewed the case.

The full 11th Circuit’s ruling in September revealed eight judges in favor of the county and sheriff against five judges who would have ruled for Lange.

Writing for the majority, Judge Andrew Brasher said the plan itself does not discriminate on the basis of sex as it excludes coverage for gender-affirming surgery regardless of an employee’s gender.

One of the judges who agreed, Robin Rosenbaum, said the situation is regrettable, as the case record shows “Houston County precludes sex-affirming surgeries for discriminatory reasons.”

In a scathing dissent, Judge Nancy Abudu said the decision creates lower-class citizens of transgender people.

The ruling allowed Houston County and its sheriff to “return the health plan to its original structure,” the parties said this week, adding they now agree the exclusion does not apply to nonsurgical care.