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Court rules insurance must pay for ex-soldier's breast surgery

The Local · 22 Oct 2009, 09:09

Published: 22 Oct 2009 09:09 GMT+02:00

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Sarah Jane Smith, 51, has been living as a woman since she began the sex change process three years ago in Hannover. But the hormones prescribed by her doctor made her breasts grow from the side of her chest, the magazine reported.

She suffered so greatly from forcing her breasts into corsets and bras that Smith applied to have a corrective operation with the DAK health insurer, with which she has been insured since 1998.

But DAK refused to pay for the €6,000-operation.

Smith took the case to court, and the judge ruled on Wednesday that DAK would have to pay for the surgery.

According to a DAK spokesperson Jörg Bodanowitz, German insurance oversight organisation MDK found that Smith fulfilled the same criteria as a born woman.

Story continues below…

“And this examination showed that there is actually a case of malpositioned breasts,” Bodanowitz said, adding that the DAK would follow the recommendation to operate.

According to Der Spiegel Smith discovered her will to be a woman at an early age, and after marrying a German woman used every opportunity alone to dress in female clothing. She divorced in 2003.

The Local (news@thelocal.de)

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Your comments about this article

14:39 October 24, 2009 by habitual_line_stepper
I'm sure there are plenty of real women who develop psychological issues because they have small breasts. That doesn't mean that insurance should pay for breast implants. If this person was psychologically traumatized (the story doesn't say that, but clearly there are those who will assume this to be true) by feeling like a woman in a man's body, I am sorry for them. But a lot of people suffer from things they can't change about themselves without surgery, etc. That does not mean that insurance should pay for it. Insurance was originally intended to pay for major losses, not for every little thing the way we expect it to now. And for the record, I think insurance companies are evil as far as most of their practices go. The person in this story has every right to live their life as a man or woman, but they do not have the right to expect insurance to pay for what they need to make them feel better. Nor should insurance pay to clean up the mess they created themselves.
09:11 October 25, 2009 by oopster
The big issue here seems to be "I don't want my insurance premiums paying for this 'man' to become a woman, he chose this", well guess what, SHE didn't choose this. This is a medical condition where the brain and the body don't match, and the only known way to correct the situation at this point in time is surgery to bring the body in line with the brain.

If you want to ban all medical procedures based on what people choose to do in order to lower your insurance premiums then you have to do it for everyone, that means anyone with cancer who smoked, sorry, you've no longer covered, you CHOSE to smoke. Anyone with kidney problems who drinks alocohol, sorry, you're no longer covered as you CHOSE to drink. Anyone getting pregnant who CHOSE to get pregnant, sorry, but you CHOSE to get pregnant.
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