Harris v. McDonough

In Harris v. McDonough, a class of transgender veterans led by Nicholette Harris challenged the Department of Veterans Affairs’ (VA) categorical exclusion of gender-confirmation surgery from its medical benefits package. The suit, filed in 2023, alleged that the exclusion violated the equal protection component of the Fifth Amendment and the Veterans Health Care Act. On February 6, 2025, the U.S. Court of Appeals for the Federal Circuit upheld a permanent injunction against the VA. The court applied heightened scrutiny and concluded that the blanket ban was not substantially related to an important government interest, and it perpetuated unconstitutional discrimination. The VA was directed to immediately cease enforcing the exclusion and to provide coverage for medically necessary gender-affirming surgical care for eligible veterans. This landmark ruling recognized the rights of transgender veterans to receive comprehensive, nondiscriminatory healthcare from the same agency that serves their cisgender peers.

The Federal Circuit affirmed the district court’s permanent injunction, declaring the VA exclusion unconstitutional and ordering the VA to cover medically necessary gender-affirming surgeries.

Whether the VA’s categorical exclusion of gender-confirmation surgery violates the equal protection guarantee of the Fifth Amendment.

The ruling was celebrated as a historic breakthrough for transgender veterans, eliminating a long-standing discriminatory exclusion. It prompted the VA to revise its healthcare policies, solidified heightened scrutiny for transgender classifications in federal benefits, and energized efforts to secure inclusive healthcare coverage across other governmental and private insurance spheres.