Transsexuals challenge rationing decision (BMJ)
Transsexuals challenge rationing decisionTranssexuals are winning sex change operations on the NHS by threatening to take health authorities to court if they refuse to pay for the surgery. The moves follow decisions by several authorities not to fund gender reassignment surgery as part of priority setting, or rationing, exercises. In the latest case Gloucestershire health authority has agreed to pay £7000 for gender reassignment surgery for a 30 year old unemployed former labourer, named as W in court papers. The authority agreed to reconsider W’s case after a High Court judge granted her leave to bring judicial review proceedings and ordered an expedited hearing. The judge had been told that W, who has lived as a woman for four years, suffered severe psychological trauma and became an alcoholic as a result of gender identity problems. She had become suicidal and had persistent thoughts of self mutilation. Gloucestershire’s chief executive, Jeffrey James, said: “The authority in setting priorities has decided that there are a number of interventions which are of low priority which in ordinary circumstances we would not fund. Sex change comes into that category.” He had taken legal advice and after reviewing the case had decided it was an exceptional one which should be funded. “Our decision doesn’t change the policy. We are currently considering the processes we go through to establish what is or is not an exceptional case.” Authorities have relented in at least four other cases where court action has been threatened or leave granted for judicial review, according to W’s solicitor, Madeleine Rees, who specialises in taking legal action on behalf of transsexuals. In another case, where the surgery had been done privately after the health authority refused to pay, the transsexual was planning to sue to recover the cost. Ms Rees said the transsexuals’ pressure group, Press for Change, hoped to mount a test case challenging blanket bans on particular types of surgery. The group plans to ask the department to draw up guidelines to health authorities and if it refuses to join the department with the health authority as a defendant. “The case could have huge implications for other types of treatment as well,” said Ms Rees.—CLARE DYER, legal correspondent, BMJ Copyright © 1996, British Medical Journal |
