⚖ Oral Arguments, with Context

The Second Circuit hears Aetna's challenge to an order requiring it to reconsider coverage for gender-affirming facial surgery. Dr. Gennifer Herley sought surgery to treat gender dysphoria. Aetna denied coverage under its policy treating facial procedures for gender transition as cosmetic. She sued, alleging sex discrimination. The district court ordered an individualized medical-necessity review, not automatic payment for surgery. The claim rests on Section fifteen fifty-seven of the Affordable Care Act, which prohibits sex discrimination in federally funded health programs. Aetna contends its policy distinguishes medical uses, not sexes. It also challenges standing: whether an order against Aetna could remedy the alleged injury when an employer controls and funds the plan. Two Supreme Court cases frame the dispute. Bostock held that firing someone for being gay or transgender violates Title Seven's ban on sex discrimination in employment. Skrmetti upheld Tennessee's restriction on certain gender-transition treatments for minors against an equal-protection challenge. The lawyers disagree about what those different rulings mean for this insurance-coverage claim.

Gordon v. Aetna Life Insurance Company (No. 26-820) — U.S. Court of Appeals for the Second Circuit, argued September 30, 2026.