Suit challenging NC ban on minors’ gender transition surgeries dismissed

All parties have agreed to the dismissal of a 2023 federal lawsuit challenging North Carolina’s ban on gender transition surgeries for minors.

The suit had been on hold since July 2025 as supporters and opponents of the ban waited for the 4th US Circuit Court of Appeals to rule in two other cases dealing with similar issues.

In Anderson v. Crouch, the 4th Circuit ruled in March that West Virginia’s Medicaid program could exclude coverage for surgeries tied to gender transition.

Now the North Carolina case Voe v. Mansfield is ending.

“[A]ll parties hereby stipulate that this action be voluntarily dismissed with prejudice, with Plaintiffs and Defendants to bear their own costs, and no fees to be awarded between Plaintiffs and Defendants,” according to a stipulation for voluntary dismissal filed Thursday.

Because the dismissal is made “with prejudice,” plaintiffs cannot refile the suit.

Lawyers representing state legislative leaders filed a July 2025 motion for a temporary stay in the Voe v. Mansfield. The lawsuit challenged House Bill 808, enacted in 2023 over then-Gov. Roy Cooper’s veto.

Neither state lawmakers nor the Voe plaintiffs wanted to move forward before the 4^th Circuit resolves Anderson v. Crouch and a separate North Carolina case, Kadel v. Folwell. The Kadel dispute involves North Carolina State Health Plan coverage for medical treatments typically sought by transgender patients. The 4th Circuit has not issued a ruling in that dispute.

The US Supreme Court issued a June 2025 ruling throwing out the 4th Circuit’s original decisions in both the Anderson and Kadel cases. The high court called on appellate judges to reconsider them in light of the Supreme Court’s Skrmetti decision. That ruling upheld a Tennessee law banning puberty blockers and hormone therapy for transgender teens.

The US Department of Justice announced in February 2025 that it was no longer fighting HB 808. A letter submitted in federal court indicated the Trump DOJ’s reversal of the Biden administration’s decision to take part in the Voe case.

“The United States hereby notifies the Court that it withdraws its Statement of Interest, filed on October 27th, 2023, as it no longer represents the United States’ position,” according to the DOJ letter.

Under Biden, DOJ officials had filed a 2023 court document branding the North Carolina law unconstitutional.

“The North Carolina General Assembly recently enacted a statute that prohibits the provision of, and use of state funds to pay for, medically necessary care to young people because of their sex and because they are transgender,” according to the Biden administration document.

“As a result [of HB 808], medical professionals in North Carolina are prohibited from administering medically necessary care for transgender minors diagnosed with gender Dysphoria — even where the minors’ parents or guardians have consented to such care — while leaving non-transgender minors free to receive the same procedures and treatments,” the 2023 court filing continued. “Similarly, medically necessary care for transgender minors diagnosed with gender dysphoria is excluded from coverage under any publicly funded health insurance or health coverage plan.”

The Biden DOJ’s statement of interest was designed “to advise the Court of its view that, by denying transgender minors — and only transgender minors — access to medically necessary and appropriate care and health coverage, H.B. 808 violates the Equal Protection Clause of the Fourteenth Amendment. Accordingly, Plaintiffs are likely to succeed on the merits of their equal protection claim.”

The legislation states “It shall be unlawful for a medical professional to perform a surgical gender transition procedure on a minor or to prescribe, provide, or dispense puberty-blocking drugs or cross-sex hormones to a minor.” The law also created penalties for medical professionals in violation, including revoking medical licenses and opening them up to civil suits from patients. In addition, HB 808 banned any use of state funds for minor sex-change treatments.

In the Senate, the veto override vote followed party lines, with no Democrat voting to override and no Republican voting to sustain. In the House, Democrat Reps. Garland Pierce of Scotland County and Michael Wray of Northampton County voted with Republicans to override.

“In some of the most liberal parts of the country, children are allowed to permanently alter their bodies with off-label drugs for the purpose of changing their sex,” said state Sen. Joyce Krawiec, R-Forsyth, in a press release after the override. “While Republicans are protecting minors from such absurd open-door policies, Democrats are siding with the furthest left of their base and putting politics ahead of documented medical risks and consequences. We need to take a cautious approach and limit access to these life-altering medical procedures, and today’s vote to override Gov. Cooper’s veto does just that.”

“Suit challenging NC ban on minors’ gender transition surgeries dismissed” was originally published on www.carolinajournal.com.