ATLANTA (AP) — Two state employees and a public school media clerk are suing the state of Georgia, saying state health insurance illegally discriminates by refusing to pay for gender-transition health care.

The lawsuit was filed in federal court in Atlanta on Wednesday by Micha Rich, Benjamin Johnson and an anonymous state employee suing on behalf of her adult child.

They argue Georgia’s State Health Benefit Plan, which insures more than 660,000 state government and public school employees and retirees, is breaking federal law.

“The exclusion not only harms the health and finances of transgender people seeking gender dysphoria treatment, it also reinforces the stigma attached to being transgender, suffering from gender dysphoria and seeking a gender transition,” the lawsuit argues. “The exclusion communicates to transgender persons and to the public that their state government deems them unworthy of equal treatment.”

The plaintiffs said the rule should be overturned and they should be repaid for the money they spent on procedures not covered by insurance. They have also requested money damages and attorneys’ fees.

The Department of Community Health, which administers the plan, declined comment, according to spokesperson Fiona Roberts.

The lawsuit cites a 2020 Supreme Court ruling that treating someone differently because they are transgender or gay violates a section of the Civil Rights Act of 1964 prohibiting discrimination on the basis of sex. The plaintiffs in that case included an employee of Georgia’s Clayton County.

The suit also argues that Georgia’s actions violate the 14th Amendment right to equal protection, and that in the case of Johnson, violate federal prohibitions against sex discrimination in education.

It’s the fourth in a line of lawsuits against Georgia agencies to force them to pay for gender-confirmation surgery and other procedures. State and local governments have lost or settled the previous suits, changing rules to pay for transgender care.

The University System of Georgia paid $100,000 in damages in addition to changing its rules in 2019 when it settled a case brought by a University of Georgia catering manager. A jury in September ordered Houston County to pay $60,000 in damages to a sheriff’s deputy after a federal judge ruled her bosses illegally denied the deputy health coverage for gender-confirmation surgery.

The Department of Community Health, which also oversees the State Health Benefit Plan, agreed to change the rules of Georgia’s Medicaid program in April to settle a lawsuit by two Medicaid beneficiaries.

The lawsuit comes as some other states seek to ban all gender-confirming care for children. Georgia could consider such a ban next year.

The plaintiffs include three transgender men. Micha Rich is a staff accountant at the Georgia Department of Audits and Accounts. Benjamin Johnson is a media clerk with the Bibb County School District in Macon. The mother of the third man, identified only as John Doe, is a Division of Family and Children Services administrative support worker in suburban Paulding County and covers the college student on her insurance.

All three were assigned as women at birth but transitioned after therapy. All three were seeking top surgery to reduce or remove breasts. All three appealed their denials and won findings from the U.S. Equal Employment Opportunity Commission that Georgia was discriminating against them. The U.S. Department of Justice also started an investigation.

“They did not accept our invitation to negotiate an end to their discrimination without litigation — and, plainly, they didn’t remove the exclusion,” wrote David Brown, legal director for Transgender Legal Defense & Education Fund, which is representing the plaintiffs..

In the meantime, Rich paid $11,200 for his surgery in 2021 and later declared bankruptcy. The Paulding County family paid $8,769 for John Doe’s surgery and is still repaying loans. Both Rich and Doe also say the state also owes them for testosterone prescriptions. Johnson dropped his state insurance and bought coverage elsewhere, having surgery in September.

“My employer should not be able to deny me health care because of who I am,” Rich said in a statement. “For years, I had to put off living my life fully while I waited to have the medical treatments that my doctors and I knew I needed.”

In question are two health plans paid for by the state but administered by Anthem Blue Cross and Blue Shield and UnitedHealthcare.

The lawsuit states insurers told the department in 2016 that transgender exclusions were discriminatory. It also says a state lawyer told health plan leadership in July 2020 that a court would likely find the rule illegal.

“Yet the defendants have knowingly and intentionally maintained the exclusion year after year, long after it became plain — and the SBHP itself concluded — that doing so is unlawful discrimination,” the lawsuit states.

A recent court ruling found a similar ban in North Carolina to be illegal. The state is appealing. A Wisconsin ban was overturned in 2018. West Virginia and Iowa have also lost lawsuits over employee coverage, Brown said, while Florida and Arizona are being sued.

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Follow Jeff Amy on Twitter at http://twitter.com/jeffamy.