In a recent court ruling, the French Social Security system was ordered to pay €3,000 in damages to two plaintiffs for not covering their gender transitioning costs.
The health insurance fund of the Seine-Saint-Denis department has apparently broken the law when it failed to cover the costs of ‘treatment’ for two women wishing to become men.
The facts of the case date back to January 2020. At the time, one of the two plaintiffs had the diagnosis of ‘gender dysphoria’ recognised as a ‘long-term illness’ by the departmental branch of the social security health fund. This classification entitled qualified patients to 100% reimbursement of medical expenses. In February 2021, when the patient underwent a bilateral mastectomy, the social security authority refused to reimburse the cost of the operation. The refusal was based on a protocol dating from 1989: at the time, in order to obtain reimbursement for gender transition costs, two years of medical follow-up were required, supervised by a surgeon, an endocrinologist, and a psychiatrist. Gender transition was not taken lightly forty years ago, and the protocol was designed to ensure that the decision was well-founded before the patient embarked on a path of no return.
However, these common-sense precautions have since been repealed under pressure from the European Convention on Human Rights, which considers that they created “unequal access to healthcare based on gender identity.”
The court therefore ordered the local health insurance fund to reimburse the plaintiff for the cost of the more than €5,300 surgery—that is, pay for it from public funds.
And this is not an isolated occurrence. The Généthique website currently lists nine similar cases pending with local branches of the social security health funds. Between 2013 and 2020, the number of people applying for ‘long-term illness’ status for gender transition increased tenfold.
The lawsuits reveal a profound paradox, rightly denounced by Marguerite Stern and Dora Moutot in their essay Transmania. For several decades, the LGBT lobby has used all its influence to achieve the ‘normalisation’ of gender change and the decriminalisation of associated practices. Transgenderism is therefore no longer considered a mental illness in France. But this normalisation, which should have been accompanied by the withdrawal of funding for related care—if changing gender is not a serious illness, why should it be covered by health insurance?—has not put an end to 100% coverage by social security for transition operations, that is, their financing by taxpayers. Compare this for instance with mandatory medical check-ups during the second trimester of pregnancy that are only 70% covered.
Stern and Moutot estimate that the average cost of a female-to-male gender transition currently exceeds €100,000. They also point out that the costs are not limited to a simple initial ‘reassignment’ operation, but include years of medical follow-up, both hormonal and surgical, which cumulatively burden the social security budget with several million euros each year. It’s clearly not cheap for apparently perfectly healthy trans people to—get well.
