PUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 20-1409 MAXWELL KADEL; JASON FLECK; CONNOR THONEN-FLECK, by his next friends and parents; JULIA MCKEOWN; MICHAEL D. BUNTING, JR.; C.B., by his next friends and parents; SAM SILVAINE, Plaintiffs – Appellees, v. NORTH CAROLINA STATE HEALTH PLAN FOR TEACHERS AND STATE EMPLOYEES, Defendant – Appellant, and, DALE FOLWELL, in his official capacity as State Treasurer of North Carolina; UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL; NORTH CAROLINA STATE UNIVERSITY; DEE JONES, in her official capacity as Executive Administrator of the North Carolina State Health Plan for Teachers and State Employees; UNIVERSITY OF NORTH CAROLINA AT GREENSBORO. Defendants. ––––––––––––––––––––––––––––––––– STATE OF CALIFORNIA; STATE OF COLORADO; STATE OF DELAWARE; STATE OF HAWAII; STATE OF ILLINOIS; STATE OF MAINE; COMMONWEALTH OF MASSACHUSETTS; STATE OF MINNESOTA; STATE OF NEVADA; STATE OF NEW JERSEY; STATE OF NEW MEXICO; STATE OF NEW YORK; STATE OF OREGON; STATE OF RHODE ISLAND; STATE OF VERMONT; STATE OF WASHINGTON; STATE OF WISCONSIN; DISTRICT OF COLUMBIA; EQUALITY NORTH CAROLINA; CLEARINGHOUSE ON WOMEN’S ISSUES; FEMINIST MAJORITY FOUNDATION; GENDER EQUALITY LAW CENTER; HARVARD LAW SCHOOL LGBTQ+ADVOCACY CLINIC; LEGAL VOICE; NARAL PRO- CHOICE AMERICA; NATIONAL CENTER FOR LESBIAN RIGHTS; NATIONAL HEALTH LAW PROGRAM; NATIONAL WOMEN’S LAW CENTER; NORTH CAROLINA AIDS ACTION NETWORK; PLANNED PARENTHOOD SOUTH ATLANTIC; WOMEN'S BAR ASSOCIATION OF THE DISTRICT OF COLUMBIA; WOMEN’S BAR ASSOCIATION OF THE STATE OF NEW YORK, Amici Supporting Appellees. Appeal from the United States District Court for the Middle District of North Carolina, at Greensboro. Loretta C. Biggs, District Judge. (1:19-cv-00272-LCB-LPA) Argued: March 11, 2021 Decided: September 1, 2021 Amended: December 2, 2021 Before GREGORY, Chief Judge, AGEE, and DIAZ, Circuit Judges. Affirmed by published opinion. Chief Judge Gregory wrote the opinion, in which Judge Diaz concurred in part. Judge Diaz wrote a concurring opinion and Judge Agee wrote a dissenting opinion. ARGUED: John Guyton Knepper, LAW OFFICE OF JOHN G. KNEPPER, LLC, Cheyenne, Wyoming, for Appellant. Omar Francisco Gonzalez-Pagan, LAMBDA LEGAL DEFENSE & EDUCATION FUND, INC., New York, New York, for Appellees. ON BRIEF: Mark A. Jones, Kevin G. Williams, BELL, DAVIS & PITT, PA, Winston-Salem, North Carolina, for Appellant. Samuel R. Bagenstos, Ann Arbor, Michigan; Tara L. Borelli, Atlanta, Georgia, Carl S. Charles, LAMBDA LEGAL DEFENSE AND EDUCATION FUNC, INC., New York, New York; Amy E. Richardson, Lauren E. Snyder, HARRIS, WILTSHIRE & GRANNIS LLP, Washington, D.C.; David P. Brown, TRANSGENDER LEGAL DEFENSE & EDUCATION FUND, INC., New York, New York, for Appellees. Xavier Becerra, Attorney General, Renu R. George, Senior Assistant Attorney General, Kathleen Boergers, Supervising Deputy Attorney General, Nicole Ries Fox, Deputy Attorney General, OFFICE OF THE ATTORNEY GENERAL OF CALIFORNIA, San Diego, California, for Amicus State of California. Philip J. Weiser, Attorney General, OFFICE OF THE ATTORNEY GENERAL OF COLORADO, Denver, Colorado, for Amicus State of Colorado. Kathleen Jennings, Attorney General, OFFICE OF THE ATTORNEY GENERAL OF DELAWARE, 2 Wilmington, Delaware, for Amicus State of Delaware. Clare E. Connors, Attorney General, OFFICE OF THE ATTORNEY GENERAL OF HAWAII, Honolulu, Hawaii, …
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