Madrid, Spain
— The Appeals court of Madrid rules against the
Madrid Health Department and for the first time
makes it pay for sex reassignment surgery.
The Social Services
Division of the Appeals of Madrid has reaffirmed a
judgment by the lower court, Social Services Division
number 30, that ruled in favour of making the Madrid
Institute of Health (IMSALUD) perform a surgical sex
reassignment involving vaginoplasty.
As a result of IMSALUD
not having appealed within the fixed time limit, the
sentence is final, making it the first time for such a
case as this in Spain, as pointed out to Europa Press by
the lawyer Soledad Olmos, who represented the
plaintiff.
Consequently, the Madrid
Health Department will have to perform the sex
reassignment surgery.
The judgment, which
Europa Press gained access to, rejected the appeal made
by IMSALUD against a previous judgment by the lower
court, Social Services Division number 30 of Madrid, and
recognized the right of the plaintiff, identified as
"Katia", "to surgical intervention for her female
genitalia." In this sense, the judgment rules that the
IMSALUD "is to carry out said intervention in the public
hospital establishment designated to that effect with the
appropriate procedures necessary according to the
therapeutic guidelines in effect.
Sexual Identity
Disorder
The Court accepts as
proven that "Katia" presents with "a sexual identity
disorder as a result of a persistent and acute
identification with the female sex, permanent signs of
belonging to the female gender, to be treated like a
woman and to experience the typical feelings of said
sex".
Also it emphasizes that
[she] suffers from "a persistent discomfort, that
in the past has been demonstrated by attempts of
self-mutilation, feelings of inadequacy, and
preoccupation with eliminating primary and secondary
sexual characteristics".
Taking this all into
consideration, the Court has established that
"[her] disorder is causing disruptions to her
social, employment and family life, and also other
important areas of [her] life".
After having pointed out
that according to the norms that are currently in effect
for sex reassignment surgery, this is not funded except
when correcting "pathological intersex conditions", the
court has determined as proven that the
plaintiff
"is profoundly
affected with a pathological intersex condition and
that the norms (guidelines in effect) require that the
sex reassignment surgery be paid by Social Security".
And further, [the
Court] pointed out that it shares the reasoning of
the Appeals Court of Catalu a (TSJC), in a similar
judgment decreed last March, requiring the Catalan Health
Department to perform a similar intervention for a
transsexual. Nevertheless, as opposed to what occurred in
Madrid, the Catalonian health system decided to file an
appeal to the Supreme Court.
In light of this, the
decision not to appeal the judgment was a surprise for
"Katia's" lawyer, who admits to being "astonished." Also,
a similar case in Alicante was filed last Spring.
However, in that case the Appeals Court of the Valencian
Community exempted the Health Department from having to
pay for the sex reassignment operation of a transsexual
because it judged that the plaintiff had as "sexual
identity problem" but not a "pathological intersex
condition".
KATIA: An Important
precedent
Speaking on her own
behalf, "Katia" expressed her satisfaction with the
judgment today to Europa Press and was of the opinion
that this established an important precedent for persons
in the same situation as she is. "Katia" explained that
she decided to file a suit for surgical reassignment in
Madrid instead of choosing other possibilities, such as
filing in Andalusia, where the procedure is covered, and
to be operated on there. The facts date back to March of
2000, when "Katia" reported to the Hospital in Madrid to
initiate the sex reassignment procedure.
After several
consultations, analyses and other tests, on March the
8th, last year, she requested vaginoplasty at a private
clinic which was part of the public health system, at
which point the IMSALUD replied that this surgery was not
covered except in cases of pathological intersex
conditions, and this is what the Court finally determined
her condition to be.
