March 9, 2026
Today, the United States District Court for the District of Connecticut enjoined Aetna Life Insurance Company’s (Aetna) exclusion of gender-affirming transition-related facial surgeries for two trans women, Jamie Homnick and Gennifer Herley, in Advocates for Trans Equality’s (A4TE) class action lawsuit. Denying Aetna’s motion to dismiss and granting the plaintiffs’ motion for preliminary injunction, the case proceeds.
“In granting the preliminary injunction, the court recognized the serious harms caused by denying access to transition-related health care, blocking Aetna from continuing to enforce its exclusion of transition-related facial surgeries against our clients while the case proceeds. This decision is an important step toward ensuring that trans people are not denied medically necessary care simply because of who they are,” said Kelly Parry-Johnson, Senior Counsel at Advocates for Trans Equality (A4TE). “For too long, insurers have relied on outdated and discriminatory policies that put trans people’s health and safety at risk. We are proud to stand with our clients as this case moves forward.”
“Having my transition-related facial surgery would mean so much to me. It’s hard to describe the relief and happiness that I feel now knowing it is possible I could finally receive care my doctors have recommended for years. I hope this decision is a step towards ensuring other trans people can access the same care without facing the same barriers I did,” said Gennifer Herley. “This preliminary injunction sends a clear message: trans people are entitled to the same medically necessary care and insurance protections as everyone else. I’m so happy that we will have our day in court.”
Gender-affirming facial surgeries are essential components of the medical treatment for gender dysphoria, a serious medical condition that arises from the incongruence between a person’s gender identity and their physical sex characteristics. Despite covering similar medically necessary surgeries for cisgender patients, Aetna categorically excludes the same procedures for transgender people, classifying them as categorically cosmetic, in violation of the Affordable Care Act.
In September 2024, Advocates for Trans Equality (A4TE), Wardenski P.C., and Cohen Milstein Sellers & Toll PLLC, filed a federal class action civil rights lawsuit against Aetna Life Insurance Company (Aetna) in the United States District Court for the District of Connecticut on behalf of Binah Gordon, Kay Mayers, S.N., Alma Avalle, Jamie Homnick, and Gennifer Herley, and other similarly situated trans people denied coverage for medically necessary gender-affirming facial reconstruction procedures. The complaint claimed Aetna violated Section 1557 of the Affordable Care Act, which prohibits discrimination based on sex in federally funded healthcare programs. The lawsuit seeks declaratory judgment, injunctive relief to end Aetna’s exclusionary policy, and compensatory damages for all policyholders who have had to pay out of pocket for gender-affirming facial surgery because of Aetna’s discriminatory exclusion.
Each of the plaintiffs have been deeply impacted by Aetna’s policy:
- Kay Mayers, a 53-year-old resident of Alaska, was unable to afford the necessary facial surgery due to Aetna’s refusal to cover the costs. She fought against Aetna’s denials of coverage for nine months before Aetna reversed course and approved coverage for the surgeries.
- Binah Gordon, a 43-year-old resident of Nebraska, was forced to cover the cost of her facial surgery herself, spending approximately $35,000 after Aetna refused to cover the surgery, causing her to experience a long, painful delay in obtaining this medically necessary care.
- S.N., a 49-year-old from Pennsylvania, paid over $40,000 out of pocket for gender affirming facial and voice surgeries. Her appeals to Aetna were mostly denied, forcing her to bear the majority of the financial burden for gender-affirming healthcare that her medical providers had deemed medically necessary.
- Alma Avalle, a 27-year-old from New York, was denied coverage by Aetna, forcing her to suffer for a protracted period of time without the surgery she needed. These denials have taken a toll on Alma, causing severe depression.
- Jamie Homnick, a 41-year-old from New York, has been denied coverage for her care by Aetna and was unable to pay for the surgeries out of pocket. Without the care she needs, she suffers from increased anxiety, depression, and symptoms of gender dysphoria.
- Gennifer Herley, a 63-year-old from New York, remains unable to obtain the health care she needs and has experienced increased symptoms of depression and anxiety related to her gender dysphoria because of Aetna’s denials. Her transition is incomplete without facial surgery.
“This ruling reflects what the law requires and what medical experts have made clear — gender-affirming care is healthcare,” said Joseph Wardenski of Wardenski P.C. “Our clients followed medical advice, navigated the appeals process, and came to court seeking fairness. Today’s decision allows them to continue that fight.”
“We are very pleased that the court has recognized, as a matter of law, that people with gender dysphoria are entitled to a medical necessity review for their gender affirming care,” said Harini Srinivasan, partner at Cohen Milstein Sellers & Toll PLLC. “Transgender people are entitled to the same process used for anyone else seeking coverage for similar procedures.”
In 2021, Transgender Legal Defense and Education Fund (TLDEF), now known as A4TE, and Cohen Milstein worked on behalf of four women denied coverage by Aetna for medically necessary breast augmentation. The insurance company eventually updated its policy and expanded coverage and removed the exclusion to include the procedure.
Plaintiffs in Gordon, et al. v. Aetna are represented by Gabriel Arkles, Ezra Cukor, Kelly Parry-Johnson, Sydney Duncan, Seran Gee, and Fiadh McKenna of Advocates for Trans Equality; Joseph Wardenski of Wardenski PC; and Christine E. Webber, Harini Srinivasan, Aniko R. Schwarcz, and Elizabeth McDermott of Cohen Milstein Sellers & Toll PLLC.
To learn more about the lawsuit or to sign up to potentially participate in the class action lawsuit, see Gordon, et al. v. Aetna Life Insurance (D.Conn.)
View the complaint.
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About A4TE
Advocates for Trans Equality (A4TE) is an organization that fights for the legal and political rights of transgender people in the United States. Introduced in July 2024 after the Transgender Legal Defense & Education Fund and the National Center for Transgender Equality merged, A4TE is the largest trans-led advocacy organization in the U.S. and brings together experts, advocates, and communities to shift government and society toward an equitable future where trans people live joyful lives without barriers.
About Wardenski P.C.
Wardenski P.C. is a civil rights law firm based in New York. The firm represents plaintiffs in civil rights lawsuits around the country challenging discrimination in education, housing, and health care, with a particular focus on the rights of the LGBTQ+ community.
About Cohen Milstein Sellers & Toll PLLC
Cohen Milstein Sellers & Toll PLLC, a premier U.S. plaintiffs’ law firm, with over 100 attorneys across eight offices, champions the causes of real people—workers, consumers, small business owners, investors, and whistleblowers—working to deliver corporate reforms and fair markets for the common good. We have litigated landmark civil rights and employment disputes before the highest courts in the nation and continue to actively shape civil rights and employment law in the United States.
Read Victory! Federal Court Orders Preliminary Relief for Trans Plaintiffs in Class Action Against Aetna.