A group of government workers filed a lawsuit this week against the Trump administration over a policy to end gender-affirming care for adults through federal employee health insurance offerings.

The five government workers who are suing the administration are being represented by the Human Rights Campaign, an organization that promotes and defends LGBTQ causes. The workers argue that the policy violates Title VII of the Civil Rights Act of 1964, which prohibits discrimination based on sex.

The lawsuit specifically targets the Office of Personnel Management (OPM), which manages health insurance plans for federal workers. In a letter sent to insurance carriers last year, OPM stated that it would no longer accept plans that included “chemical and surgical modification of an individual’s sex traits through medical interventions (to include ‘gender transition’ services).” However, OPM still allows plans to cover the same procedures for cisgender employees in other situations.

“By prohibiting coverage for gender-affirming care, OPM has discriminated, and continues to discriminate, against Plaintiffs and the class they represent on the basis of sex,” the lawsuit declares.

The new OPM guidance does allow for insurers to continue providing care to transgender recipients if they are “mid-treatment” — that is, if they began receiving gender-affirming care before the new policy was implemented. However, as the plaintiffs point out, the agency “does not define ‘mid-treatment,’ identify the criteria carriers must or should use to determine whether a beneficiary qualifies for an exception, specify how beneficiaries may seek review of an adverse determination, or address whether beneficiaries who chose or were forced to change…plans for Plan Year 2026 are eligible for the exception.”

“This exceptions process itself constitutes additional discrimination on the basis of sex,” the lawsuit adds. “It requires beneficiaries seeking gender-affirming care to go through a separate process that OPM does not require for other medically necessary care; imposes heightened uncertainty for transgender and gender non-conforming beneficiaries as to what, if any, of their gender-affirming medical care will be covered; and it categorically forecloses coverage for those who have not yet commenced a hormonal or surgical course of treatment.”

The five workers who are suing the administration chose to remain anonymous. They cite a range of gender-affirming treatments (including hormone replacement therapy, or HRT, therapy sessions, and surgical care) that will cost them thousands of dollars out-of-pocket because they are no longer part of their insurance policies. One individual involved in the lawsuit could pay as much as $100,000 out of pocket due to the new policy.

The plaintiffs aren’t just workers who are seeking gender-affirming care options, but also workers whose “transgender or gender non-conforming spouses and children [are] enrolled as dependents” under their health plans.

The class action lawsuit seeks to block the new policy and for plaintiffs to receive compensatory damages for the expenses they’ve already had.

Although comprising a small proportion of the overall federal workforce, the policy changes could affect 314,000 federal workers, the estimated number of transgender people who work for the U.S. government.

Kelley Robinson, president of the Human Rights Campaign Foundation, called out the Trump administration for targeting trans federal workers.

“Healthcare access should never be weaponized to advance discrimination — and the denial of coverage for critical healthcare based simply on who you are blatantly violates the rights of all of us,” Robinson said in a statement, adding:

This odious policy is the latest example of the Trump administration’s obsession with targeting transgender people, using shameful and cruel tactics to threaten their employment, their health and the well-being of themselves and their families.