On August 2, 2022, federal District Court Judge Robert C. Chambers granted affirmative summary judgment for Plaintiffs in Fain et al. v. Crouch et. al, and ruled that West Virginia could no longer discriminate against transgender Medicaid participants by excluding coverage for gender-confirming surgical care. In their complaint, Plaintiffs alleged that West Virginia state health insurance plans deprive transgender people of essential, and sometimes life-saving, health care.