US District Court Judge Rosemary Marquez affirmed the final consent decree in the case Toomey v. State of Arizona on Tuesday, banning Arizona from excluding gender-affirming care in state health insurance plans.

The consent decree includes four major provisions: the state is permanently enjoined from not including gender-affirming care in the state health plans, the state health plans must evaluate requests for coverage for gender-affirming treatments and surgeries the same as all other types of healthcare coverage, the state will no longer apply any statutes or rules that are in conflict with the consent decree and the state will pay the plaintiff’s legal fees. Judge Marquez evaluated the consent decree and affirmed that it met the appropriate legal standards for class action settlements.

Attorneys for the plaintiff, Willkie Farr & Gallagher LLP, celebrated the affirmation of the consent decree, stating, “Ending five years of litigation, the consent decree permanently prohibits the state of Arizona from excluding gender-affirming care from its employee health plan.”

The case was originally filed in 2019 by Russell Toomey, an Associate Professor at the University of Arizona. Toomey alleged he was denied gender-affirming care to aid in his transition. Toomey claimed that the denial of coverage for his transition-related care amounted to discrimination based on sex, in violation of the 1964 Civil Rights Act and the Fourteenth Amendment of the US Constitution. In June, Arizona Governor Katie Hobbs signed an executive order ensuring that gender-affirming medical care would be covered by the state health plans.