CHARLESTON, W.Va. (AP) — A federal judge has ruled that West Virginia’s Medicaid program must provide coverage for gender-confirming care for transgender residents.

The judge made the ruling Tuesday in a lawsuit filed 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 on the basis of sex and transgender status. Chambers certified the lawsuit as a class action, covering all transgender West Virginians who participate in Medicaid.