A federal judge has ruled that West Virginia’s Medicaid program must provide coverage for gender-confirming care for transgender residents.

The judge ruled Tuesday in a lawsuit by LGBTQ interest group Lambda Legal.

The lawsuit accused the state of violating the Affordable Care Act and Medicaid law by not covering treatments for gender dysphoria.

The lawsuit also named state employee health plans.

Chambers said the Medicaid exclusion discriminated based on sex and transgender status.

Chambers certified the lawsuit as a class action, covering all transgender West Virginians participating in Medicaid.