Sergeant settles lawsuit with Houston County on gender-affirming care insurance policy
A Houston County sergeant has settled her lawsuit with the county in a case that argued the employer-provided health plan discriminated against the transgender community.
Sgt. Anna Lange, a transgender woman who’s worked for the Houston County Sheriff’s Office since 2006, settled her lawsuit with county officials, according to a June 3 news release from Advocates for Trans Equality.
Her case dealt with whether her gender-affirming care should be covered by the county’s insurance plan with Blue Cross Blue Shield.
The settlement marked the end of a seven-year legal battle.
Timeline of the case
In February 2019, Lange asked Houston County commissioners to include treatment for gender dysmorphia in their insurance plan, but they said no.
She sued after being denied medical coverage for gender-affirming surgery under the county’s insurance plan with Blue Cross Blue Shield on Oct. 2, 2019. She claimed that excluding services and medication for sex change surgeries violated the Civil Rights Act of 1964 and the Equal Protection Clause under the 14th Amendment, the news release said.
The sergeant was granted summary judgment by Judge Marc Treadwell in June 2022. He also ordered the county to notify Blue Cross Blue Shield to stop excluding coverage for gender-affirming surgeries. A jury trial also ruled in Lange’s favor, awarding her $60,000, according to previous Telegraph reporting.
The litigation continued since Houston County appealed the ruling and the jury’s verdict. During this time, Lange had gender-affirming surgery that was covered by insurance, according to previous Telegraph reporting.
Houston County paid more than $1.2 million to fight Lange in court, according to ProPublica reporting in The Telegraph in 2023.
However, the ruling was later vacated by the Court of Appeals for the 11th Circuit in September 2025. The judges reconsidered their previous ruling after a Supreme Court decision in a Tennessee case. Justices ruled there needed to be a qualifying diagnosis to have gender-affirming surgery covered, according to previous Telegraph reporting.
“The fact that the plan excludes coverage for one treatment for gender dysphoria is not a penalty in any sense of the word,” court records show. “The plan does not, for example, impose a surcharge on employees who have undergone a sex change. Instead, the plan declines to extend a benefit — namely, coverage for a sex change operation.”
Houston County enforced the exclusion in its health plan with Blue Cross Blue Shield after the ruling was vacated, the news release said.
The resolution
“The Parties now agree the Exclusion does not apply to nonsurgical care,” the news release said. “Given those facts, and to avoid the costs associated with further litigation, the Parties decided to resolve the lawsuit.”
The county agreed to reimburse Lange $5,000 for out-of-pocket expenses during her treatment, the news release said.
“The County returned the Health Plan to its original coverage, except that any procedures contemplated at the time of and that arise out of Sgt. Lange’s original surgery would be covered,” according to the news release.
Lange remains a sergeant for HCSO.
Her story
Lange told The Telegraph in 2019 that her transition started in 2004, but held off to focus on her marriage and raising her son.
By 2017, she was diagnosed with gender dysphoria. She told the Houston County Sheriff’s Office that she would begin being openly female at work, to which the sheriff gave “unspoken support,” according to previous Telegraph reporting. She “finally realized that this is what I needed to do,” she told The Telegraph.
She argued that gender-affirming surgery isn’t a cosmetic procedure, but a medical necessity.
“Some people said that I just want publicity, but if I had just had health insurance you would’ve never heard of me,” she said.
Lange’s hobbies include bicycling, beekeeping and refereeing soccer games.
This story was originally published June 11, 2026 at 2:58 PM.
