A U.S. appeals court has upheld West Virginia's ban on Medicaid coverage for gender-affirming surgeries, a move seen by Republican-led states in an ongoing battle over transgender rights. The court stated that the law does not unlawfully discriminate against transgender people and applies only to specific procedures. The type of surgeries involved are those that align with a person's gender identity, such as chest reconstruction, genital alteration and facial procedures. West Virginia Attorney General John McCuskey argued that subsidizing "unproven, non-essential medical procedures" could deprive the state of funding used to treat cancer, heart disease, and diabetes. The Trump administration has proposed barring providers from receiving funds under the Medicare and Medicaid government insurance programs if they provide gender-afirming treatment to minors.