Trans Fear Court Decision Will Prevent Insurance Coverage for Sex Reassignment in Brazil

Superior Court of Justice decision released operators from paying for procedures outside the National Supplementary Health Agency list

Thalita, 21, is anxious. The young transsexual from São Paulo seeks, in court, that a health operator pays for her transgender surgery — alteration of Organs genital —, which she has been waiting for for years. She and several other trans people feel insecure after a decision by the Superior Court of Justice (STJ) changed the understanding of the National Supplementary Health Agency list of procedures. On the 8th, the justices of the STJ decided that the list should be exhaustive, exempting health plans from paying for procedures not included in it. Previously, the list was seen as an example, opening loopholes for users to seek the cost of procedures outside it in court.

Transgenitalization is not part of the ANS list and, with current understanding, can be promptly denied. Although the decision of the STJ ministers is not binding, it tends to be followed by judges across the country. Thalita, who has been on hormone treatment since the age of 18 and has been in psychological counseling for even longer, fears the consequences of the STJ's decision.

Lawyer Claudia Ramos, a member of the Sexual and Gender Diversity Commission of the Brazilian Bar Association and a member of the Mães pela Diversidade collective, says that it has never been easy to get health care providers to pay for sex reassignment surgery. But the Judiciary, many times, accepted the requests. Now, she assesses, the tendency is for these procedures to be denied, and hope lies in the Supreme Court. "[The STJ's decision] is an injury to the Constitution, which enshrined the principle of human dignity as one of the fundamental principles of the democratic rule of law. It's the light we see at the end of the tunnel."

Translated by Kiratiana Freelon

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