Health insurance must cover facial feminisation surgery, court rules

Female eye sockets tend to be smaller, and the orbit recontouring operation reduces the eye socket bones. Keystone

For the first time in Switzerland, a court has ruled in favour of a transsexual person in a case brought against their health insurer. Basic coverage must pay for the woman’s face surgery which was the last stage of her sex reassignment process.

Swiss public television RTS reported on Wednesday that the Geneva woman had won a case that had lasted more than two years.

Lynn Bertholet began her gender reassignment process in 2014. Born a man, she initially underwent a primary reassignment operation on her reproductive organs and had a breast operation.

She then underwent a procedure called orbit recontouring. Female eye sockets tend to be smaller, and this operation reduces the eye socket bones.

“Three surgeons explained to me that my face had pronounced features – my eye socket bones – and that by surgically reducing them, I would feel better,” said Lynn in an interviewExternal link with RTS.

+ Find more about the LGBTIQ community in Switzerland

She concluded that the operation, which cost CHF5,780 ($5,785) was necessary to complete her gender reassignment process, before which she had felt like “a woman living in the wrong body.”

Cosmetic vs. medical

The health insurance company, Groupe Mutuel, refused to cover the cost of the facial surgery, arguing that it “must be considered an aesthetic improvement” in the same way that the “modifying the facial appearance of a biologically born man or woman” would be.

But the court decided that the insurer will have to reimburse Bertholet the full amount of the operation.

The Swiss Patient’s AssociationExternal link applauded the decision and said it was sensible for an insurance company to pay for a one-off operation rather that covering alternative treatments which could last years or even decades.

Facial feminisation surgery for transgender people was not an aesthetic procedure but a medically necessary intervention to treat an illness called “gender dysphoria”, said Simon Zurich, vice president of the association in French-speaking Switzerland.

There was no appeal lodged against the Geneva court’s decision, and the ruling could set a precedent for similar cases throughout Switzerland, reported RTS.

​​​​​​​