The American Civil Liberties Union of Arizona (ACLU of Arizona) filed a lawsuit on Wednesday against Arizona for denying a transgender state employee health coverage for gender reassignment surgery.

The plaintiff, Russell Toomey, is an Associate Professor at the University of Arizona who participates in the state’s self-funded health plan. Toomey claims that by denying him treatment for his transition-related care, Arizona is discriminating transgender employees on the basis of sex.

Toomey is currently undergoing transition-related care, in which his physician prescribed a hysterectomy surgery to treat his gender diaspora. The plan provided to state employees offers coverage for most all “medically necessary care.” This includes hysterectomies that are prescribed by physicians as a necessary treatment for a medical condition. However, the plan has refused to cover surgeries when the purpose is gender reassignment.

The complaint filed provides exhibits showing that all insurance providers participating in the plan adopted policies for determining the medical necessity of a transition-related surgery. These policies, plaintiffs argue, show that they are instances of coverage but due to the exclusion, coverage is automatically denied without evaluation from the insurance provider.

Toomey argues that excluding coverage of procedures for purposes of gender reassignment without evaluating its medical necessity is a form of sex discrimination. Therefore, the plan is in violation of Title VII of the Civil Rights Act of 1964. Additionally, Toomey alleges that transgender employers are denied equal treatment of medical care and seek protection under the Equal Protection Clause of the Fourteenth Amendment.

In Wisconsin, a recent ruling upheld that denying state employees coverage of gender-affirming care violates the Constitution. In similar fashion, Toomey requests an injunction to remove the discriminatory exclusion within Arizona’s health plan to restore the plaintiffs’ constitutional rights.