Health insurance plans run by U.S. states must cover gender-affirming surgeries for transgender people, a U.S. appeals court ruled on Monday. The 8-6 opinion from the Richmond, Virginia-based 4th U.S. Circuit Court of Appeals upheld two lower court rulings, which had found that North Carolina's state employee health insurance plan discriminated against transgender people by not covering surgeries for "sex changes or modifications," and that West Virginia's Medicaid program discriminated by exclu