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Woman sues insurer for discrimination

On Behalf of | Aug 4, 2019 | Insurance Law |

Most people in Washington State would assume that their health insurance companies would pay for any procedures that were recommended as medically necessary by a physician. Unfortunately, this does not always happen and some people end up being forced to endure challenges due to their inability to receive the treatments they need. In some cases, patients may need to take serious steps to advocate for their health.

A woman in Oregon is today in this type of situation and, after multiple years of being denied coverage for a surgery that her doctors said is medically required, she is taking action with a new discrimination lawsuit. As reported by Oregon Live, the woman was identified as a male when she was born but early on in her life realized she was female. She has since undergone a gender transition that included taking hormone replacement therapy drugs, having surgery and making other lifestyle adjustments.

Despite the efforts she has taken thus far, her facial structure still appears largely male and this has caused her significant problems and she has been diagnosed with gender dysphasia. Her doctors recommend that she undergo a female facialization surgery to make her face more clearly and visibly appear as a woman. They have indicated this is the medically necessary means of addressing her condition.

The American Medical Association and the American Psychiatric Association agree that this surgery is necessary and not elective yet her medical insurance company argues against this and will not agree to pay for the procedure despite paying for the same procedures to treat other conditions for other patients.