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OPM directed federal health carriers to exclude gender-affirming care from FEHB, PSHB coverage

The U.S. Office of Personnel Management issued FEHB Program Carrier Letter 2025-01b on August 15, 2025, directing all Federal Employees Health Benefits and Postal Service Health Benefits carriers to exclude coverage for hormone treatments and surgical procedures tied to gender transition, effective Plan Year 2026. On August 3, 2026, the Human Rights Campaign Foundation and federal employees filed a class-action lawsuit alleging the exclusion violates Title VII's sex-discrimination protections.

Jurisdiction
Federal
Location
Washington, D.C.

Abuses documented

Actors

On August 15, 2025, the U.S. Office of Personnel Management issued FEHB Program Carrier Letter 2025-01b, directing all Federal Employees Health Benefits and Postal Service Health Benefits carriers to exclude coverage -- effective Plan Year 2026 -- for "chemical and surgical modification of an individual's sex traits through medical interventions," eliminating gender-affirming care coverage for federal workers, retirees, and dependents enrolled in the programs. Associate Director D. Shane Stevens signed the directive on OPM's behalf.

The exclusion took effect January 1, 2026, ending hormone and surgical coverage for gender transition purposes across FEHB and PSHB plans, though it retained coverage for gender-dysphoria counseling and required carriers to set up case-by-case exception processes for enrollees already mid-treatment.

Updates

2026-01-01 — HRC Foundation filed complaint against OPM over the coverage exclusion [4, 5]

The Human Rights Campaign Foundation and law firm Correia & Puth filed a class-wide administrative discrimination complaint against the U.S. Office of Personnel Management the day the coverage exclusion took effect, alleging the policy violated Title VII's sex-discrimination protections and seeking rescission of Carrier Letter 2025-01b.

2026-02 — HRC Foundation escalated the case to the EEOC [6, 7]

After OPM did not resolve the complaint within its 30-day response window, the Human Rights Campaign Foundation and law firms Correia & Puth and Cohen Milstein Sellers & Toll filed a class complaint with the Equal Employment Opportunity Commission, triggering a 180-day window before the case could proceed to federal court.

2026-03-03 — Rep. Randall led 43 Democrats demanding OPM answers on the coverage exclusion [8]

Congresswoman Emily Randall and 42 other House Democrats sent a letter to OPM Director Scott Kupor opposing the coverage exclusion, arguing it violated Title VII's sex-discrimination protections under the Supreme Court's Bostock v. Clayton County ruling and that OPM's August 2025 announcement gave federal employees insufficient notice to make informed choices during the 2026 open enrollment period. The letter demanded OPM provide written answers within 14 days to seven questions covering the legal basis for the decision, its internal process, enrollee notification, and impact assessments.

2026-08-03 — HRC Foundation, federal employees sued OPM over the coverage exclusion [2, 3]

The Human Rights Campaign Foundation and law firm Correia & Puth filed a class-action lawsuit in federal court on behalf of transgender federal employees and their families, alleging OPM's exclusion violates Title VII's sex-discrimination protections. A Williams Institute study cited in HRCF's announcement estimated the policy affects health access for at least 39,400 current and former federal employees and dependents.

Why we recorded this

Equal treatment in federal employment means benefit programs should not carve out coverage based on an employee's transgender status. OPM's directive strips gender-affirming care coverage specifically for transgender federal workers and dependents while leaving comparable medical treatments covered for other conditions -- a policy federal employees argue amounts to sex discrimination under Title VII. This archive records when government uses control over employee benefits to single out a protected class for exclusion.

Sources

  1. FEHB Program Carrier Letter 2025-01b — U.S. Office of Personnel Management primary accessed August 4, 2026
  2. 'We'll See You in Court': Human Rights Campaign Foundation Files Class Action — Human Rights Campaign Foundation secondary accessed August 4, 2026
  3. Federal workers sue over rule barring gender-affirming care coverage — MS NOW secondary accessed August 4, 2026
  4. Human Rights Campaign Foundation Launches Class Action Against Trump Administration on Behalf of Federal Workers and Their Families Over Loss of Gender-Affirming Healthcare Coverage — Human Rights Campaign Foundation primary accessed August 4, 2026
  5. US federal employees file complaint against Trump's anti-transgender policy — Al Jazeera secondary accessed August 4, 2026
  6. Human Rights Campaign Foundation Takes Next Step in Class Action Litigation Against Trump Administration: Files Complaint with EEOC Over Prohibition on Gender-Affirming Healthcare Coverage for Federal Employees — Human Rights Campaign Foundation primary accessed August 4, 2026
  7. Trump administration's denial of gender-affirming care to federal employees is unlawful, says LGBTQ+ group — The Advocate secondary accessed August 4, 2026
  8. Randall Leads 43 Democrats in Demanding Answers from OPM Over Decision to Eliminate Coverage for Medically Necessary Trans Health Care — Office of Rep. Emily Randall primary accessed August 4, 2026

See also