FOR IMMEDIATE RELEASE

May 4, 2000

Court Orders State to Provide Health Care to Transsexual Woman

Massachusetts Court Orders State to Provide Health Care to Transsexual Woman

(Boston, MA) The Suffolk Superior Court today ordered the state to pay for breast reconstruction surgery for a transsexual woman, reversing its earlier denial. Gay & Lesbian Advocates & Defenders (“GLAD”) represented the Plaintiff Germaine Beger in her appeal. Judge Maria Lopez found that a decision by the Division of Medical Assistance (“DMA”) was arbitrary and based on an incorrect interpretation of the state agency’s regulations.

Commented Jennifer Levi, GLAD staff attorney who represented Ms. Beger, “This decision highlights the discriminatory way transsexual people are often treated within the health care system. Ms. Beger was denied basic medical care simply because she is transsexual, despite the fact that she is medically and legally a woman. Judge Lopez’ ruling makes clear that denying basic health care needs simply because someone doesn’t fit a stereotype of what society thinks is a real woman or a real man is not a correct interpretation of our law.”

Ms. Beger is a 50 year-old Medicaid recipient who completed sex-reassignment surgery over 25 years ago. As part of her sex-reassignment surgery in 1975, she received breast implants. In 1999, she sought treatment for a possible cyst in her right breast and learned that she needed to have the implants removed, followed-up with breast reconstruction surgery. DMA approved the removal but denied the follow-up breast reconstruction surgery citing a state regulation that excludes Medicaid coverage for sex-reassignment surgery. During the appeals process, DMA refused to make any individualized consideration of medical necessity, as it would for a non-transsexual woman in similar circumstances, stating simply that the law excludes transsexual women from receiving even basic health care coverage for treatments relating to being female.

“I am relieved by this outcome. Denying coverage for a procedure which my surgeon told me was medically necessary simply because I am transsexual is wrong. I hope this decision sends a clear message that it is unlawful to deny basic health care to transsexual people simply because of stereotypes, bigotry and misunderstanding,” Germaine said after hearing of the decision.

The Court’s order directs DMA to authorize payment for the procedure. There is no information regarding whether the state intends to appeal.