Amelie Koran is a federal employee who was denied coverage for transition-related care under the Federal Employees Health Benefits Program (FEHB). The federal Office of Personnel Management is the agency responsible for administering the FEHB, which provides health insurance coverage for millions of current and former federal employees across the country.

Mark Horton was offered a job as Vice President of Sales and Marketing at Midwest Geriatric Management, LLC, only to have the offer withdrawn after the company learned he had a same-sex partner. A U.S. district court in Missouri dismissed his discrimination claim under Title VII of the Civil Rights Act of 1964 based on a case from the 1980s stating that Title VII does not protect lesbian, gay, and bisexual people from discrimination.