In this case, a Superior Court in Suffolk County ordered the state of Massachusetts to pay for a surgical procedure it had denied to a transsexual woman, but would have provided to a non-transsexual woman.  Germaine Beger is a 50-year-old Medicaid recipient who completed sex-reassignment surgery over 25 years ago, including receiving breast implants.  In 1999, she sought treatment for a possible cyst in her right breast and learned that she needed the implants removed and follow-up breast reconstruction surgery.  The state approved the implant removal but denied the breast reconstruction, relying on a state regulation that excludes Medicaid coverage for any procedure related to sex-reassignment surgery.

GLAD successfully argued that breast reconstruction in this case was not related to sex-reassignment, since Germaine had been legally and medically a woman for half a lifetime.  The Court ruled that the state could not refuse a medically necessary procedure simply on the basis that Germaine is a transsexual.