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Susan Linehan's avatar

I understand our limited information about this appeal, but I am wondering whether at the trial level there was any evidence of WHY transgender surgery was excluded. Was it the decision of the insurer, reflected in policies elsewhere, that such surgery is "cosmetic" as presumably breast enhancement surgery or face life surgery is? Or was the county presented with a choice whether to include or exclude transgender surgery and chose to exclude it in their particular package? If the latter, what was the cost savings of choosing such a plan? It is hard to imagine that county employees would deluge the insurer with such requests, such that there would be significant cost savings of a group plan to exclude it.

I don't AGREE that sex change surgery is "cosmetic" but I can see an insurance company deciding it is. In general, do insurers routinely exclude it for that reason, or is this unusual? Does an insurer who deems such surgery in general cosmetic have an appeals process by the doctor as to why in a particular instance it is more than that?

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Michael A Goodwin's avatar

Trans-gender people are NOT the only class. People born with 2 sex organs,once called hermaphodites, are also a class that would play into this decision.

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