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Strasbourg Court Orders Full Coverage for Trans Man’s Gender-Affirming Surgery

The landmark ruling also awards €3,000 in damages, citing discrimination by France’s Bas-Rhin health insurer.

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La CPAM du Bas-Rhin va devoir prendre en charge la mastectomie d’un homme trans.
Un jeune homme trans, qui contestait en justice le refus de la Caisse primaire d’assurance maladie (CPAM) du Bas-Rhin de prendre en charge sa mastectomie, a obtenu gain de cause, a indiqué mercredi 14 mai 2025 son avocate. Photo d’illustration.

Overview

  • The Strasbourg tribunal ruled on May 14, 2025, that CPAM du Bas-Rhin must fully fund a trans man’s bilateral mastectomy, overturning its earlier partial refusal.
  • The court also ordered CPAM to pay €3,000 in damages, recognizing the insurer’s actions as discriminatory and a violation of privacy rights under European human rights law.
  • The plaintiff, who began his transition in 2017 and started hormone therapy in 2022, faced systemic barriers, including a lengthy appeals process and outdated medical protocols cited by CPAM.
  • This decision is the first in France to explicitly label such refusals as discriminatory, potentially setting a precedent for eight similar lawsuits against regional insurers currently pending.
  • Advocacy groups and legal experts see the ruling as a step toward ensuring equitable access to gender-affirming care under France’s healthcare system.