A transgender woman is suing his insurance company for refusing to pay for his facial reconstruction.

Oregon Live has reported:

A transgender woman in Oregon has filed a $375,000 lawsuit against her insurance companies and her employer, saying they’ve discriminated against her by refusing to pay for facial surgery that would make it more likely that strangers would perceive her as female.

Christina Ketcham, a 59-year-old Clatsop County employee, has already undergone sex reassignment surgery, hormone replacement therapy, worked with a voice coach and changed her name, clothes and hairstyle to reflect her gender identity, but her doctors also recommend that she undergo ‘facial feminization surgery’ to continue on that path.

Ketcham’s policy does not cover cosmetic surgery. The insurance company supports members with comprehensive, medically necessary transgender services but does not consider trans facial reconstruction ‘medically necessary’ as a treatment for gender dysphoria.

“There is no medical test that can define or prove gender dysphoria,” said Kirralie Smith, Binary spokeswoman, “It is a psychological issue. Some doctors and lawyers are insisting it be treated with surgery at the expense of the insurance company. A line must be drawn somewhere. There are a lot of people who desire cosmetic surgery, but that doesn’t mean the insurance company should pay for it.”