Transsexuals win right to sex change on NHS By Terence Shaw Legal Correspondent TRANSSEXUALS won the right to have sex change operations on the NHS yesterday after a landmark ruling by the Court of Appeal recognised the condition as a legitimate illness. The ruling means that 1,000 transsexuals in Britain awaiting sex change operations, will be able to have their surgery free. Health authorities will have to foot the £8,000 bill for each sex change operation after the Appeal Court upheld a High Court ruling in December that three transsexuals were entitled to surgery on the NHS. The three, who live as women, won their test case when three judges upheld the ruling that the decision of the North West Lancashire Health Authority to deny them surgery because of higher priorities on its funds was unlawful. Solicitors for the three women, referred to in court by initials to protect their identity, said the judgment was a “landmark in the continuing struggle for legal recognition” of the rights of transsexuals. It meant health authorities had to assess treatment for transsexuals as if they were suffering from a disease rather than in need of cosmetic surgery. In his judgment, Lord Justice Auld said the health authority’s policy was flawed because it did not treat transsexualism as an illness but as an attitude or state of mind that did not warrant medical treatment. Its attitude amounted to a blanket policy against funding treatment for the condition “because it does not believe in such treatment”. Agreeing that the appeal should be dismissed, Lord Justice Buxton said the health authority had not shown “rational consideration” before deciding to “give no funding at all to a procedure supported by respectable clinicians and psychiatrists, which is said to be necessary in certain cases to relieve extreme mental distress”. The test cases were brought on legal aid by Miss A, aged 21, Miss D and Miss G, both aged 50, who were refused gender reassignment surgery in 1996 and 1997 after it was decided that none of them had shown an “overriding clinical need”. The health authority claimed that it was entitled to take into account its own “scarce resources” and to refuse funding for the operations if it meant funding for serious illnesses, such as heart disease, cancer, kidney cases and Aids would suffer. Lord Justice Auld said the women, who suffered from “gender identity dysphoria”, commonly known as transsexualism, were born with male physical characteristics but psychologically had a female sexual identity. All three had been living as women for many years and A and G had been diagnosed by a specialist consultant to have a clinical need for surgery substituting female for male characteristics. D was awaiting assessment of suitability for surgery. 22 December 1998: Judge backs sex changes on NHS
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