This is a case that set a judicial ruling and was refered to in the case of Cambridge Health authority. Regarding this particular case the North West Lankashire Health Authority subsequently appealed the judgement and lost.

The original cost as to each appellants surgery was muted at £8000. Total cost for this case and the subsequent appeal by the HA.was in the region of £1.2M the health authority paying to order 66% of costs and 33% being paid by legal aid, so basically 100% by the tax payer, this did not include compensation or any punative damages awarded.


Landmark transsexual ruling upheld
Health



Three transsexuals have reached what they hope is the end of a long legal battle to have their health authority pay for their sex change surgery.
The ruling confirms gender reassignment therapy as a necessary medical treatment rather than a cosmetic procedure - meaning it should be available on the NHS.
The three won a High Court case against last North West Lancashire Health Authority last December, when Mr Justice Hidden said the authority's refusal to pay was "unlawful and irrational" and had been taken without consideration of what was "the proper treatment of a recognised illness".
The authority appealed, but on Thursday the Court of Appeal upheld the original ruling.
Trapped
Known only as A, D and G to protect their identities, the three were described as females trapped in male bodies since birth.
They had already started "gender reassignment" treatment - mostly involving hormones - but in 1996 and 1997 were refused surgery after it was decided none of them had shown a demonstrable "overriding clinical need" for treatment.
Lord Justice Auld said in Thursday's judgement: "The health authority's policy in my view, is flawed in two important respects.
"Firstly it does not in truth treat transsexualism as an illness but as an attitude or state of mind which does not warrant medical treatment."
The second flaw was that it amounted to a blanket ban based on the authority's distaste for the procedure.
'Money wasted'
Stephen Lodge, a solicitor for Tyndallwoods, which represented the three, said after the hearing that the appeal had delayed his clients' treatment.
"The money (the health authority has) spent on this case could have gone towards treating our clients. We trust that now the health authority will reconsider its policy and agree to fund our clients' treatment without further delay."
He said the decision represented a "landmark in the continuing struggle for legal recognition" of the transsexuals' rights.
David Edmundson, chief executive of the authority, said: "We have always had sympathy for the applicants, but that has always been constrained by the funds available and our priorities.
"We didn't enter into this light-heartedly and we have always felt our policies were reasonable.
"This was never done just because of the cost of the treatment. We are saying that we have so much money and we have to ensure it is used as effectively as possible."
'Overdue victory'
Christine Burns, spokeswoman for the transsexual rights group Press for Change, said the victory was "long overdue".
"It at last shows common sense in realising that this is a medical condition for which this is the only treatment that works," she said.
"This is not something that is entered into lightly. People who get to the stage of being ready for surgery have been through many years of other treatment."
She said that less than two in 10 people who came forward for treatment reached the stage of going onto surgery.

In brief the Conclusion on the subsequent appeal is as follows.


LORD JUSTICE MAY: I agree that these appeals should be dismissed for the reasons given by Auld and Buxton LJJ, and I concur in the orders proposed.

The decisions of the Health Authority which the respondents successfully challenged before Hidden J were applications of the Authority's 1995 and 1998 policies. As Auld LJ demonstrates, these policies were made upon the premise that transsexualism is not a disease and that surgical treatment for it is of no proven clinical benefit. But it was accepted before Hidden J and before us that transsexualism is an illness. Mr Pannick QC implicitly accepted that, if "disease" and "illness" might conceivable sometimes have different shades of meaning, the difference is immaterial in the context of the Health Authority's delegated responsibility under section 3 of the National Health Service Act 1977 to provide reasonable facilities for the treatment of illness. The first part of the premise upon which the policies proceeded is therefore erroneous. The strong balance of the evidence before the court is that the second part of the premise is also erroneous. But it is neither necessary nor appropriate for the court to determine that debate.

Health Authorities have to make hard and often invidious decisions in the allocation of avowedly inadequate resources. But those decisions must proceed from proper assessments of the conditions competing for treatment. The decisions in the present cases did not so proceed, and I agree that they and the policies, so far as they relate to transsexualism, require reconsideration.

I also emphatically agree that the European Convention of Human Rights has no impact on these applications and that inapposite forensic reference to cases decided under the Convention was not helpful.


ORDER: All three appeals dismissed.{an appeal against each of the TG's previous victory} Appellant {The health authority}to pay 66% of the respondents' costs. Leave to appeal refused.

(Order not part of approved judgment)

This is the recomendations and reports regarding the Cambridge health authority. Rather long winded, but some will find it interesting. I know of several members of this site that are having dificulties progressing their cases, Law is boring until you need it.

http://www.translondon.or[...]ged.pdf


In Conclusion

Oxfordshire PCT's funding policy for genital reassignment surgery represents
an anomaly among the collected policies of PCTs within NHS South Central.
We trust that the increased role of the SHA in determining local priorities, and
in particular, the impact of the recently established Special Commissioning
Group (SCG) for this region, will result in amendments to Oxfordshire PCT's
policy, to place this county in line with the rest of the region. Besides
eliminating the inequalities inherent in the present 'postcode lottery', such
intervention might be expected to result in a more enlightened and rational
policy for Oxfordshire.
30

Our Conclusions – a Review
In summary, we believe that Oxfordshire PCT’s current policy for the funding
of treatment for gender dysphoria is in urgent need of review, together with its
established practice in this area. We do not feel that the PCT has given
proper consideration to the available evidence-based research and specialist
advice it has been presented with; these deficiencies have resulted in
inappropriate prioritisation of treatment. The PCT's estimation of ‘exceptional
circumstances’ lacks internal rationality, rendering its policy meaningless in
practice, such that an effective blanket ban has been imposed on appropriate
and necessary surgical procedures. Such policy is inconsistent with that
adopted by all other PCTs in the region.
We consider these lapses to be negligent and unethical, and potentially
symptomatic of institutionalised discrimination against transgender people.
We advise those responsible for local priority-setting to make the necessary
amendments to Policy Statement 18b as a matter of urgency.

United Kingdom and a Bench Mark in changing attitudes and the law


Historically in the United Kingdom, transsexual people had succeeded in getting their birth certificates changed and marriages conducted. However, this was not legally tested until the case of Corbett v Corbett in 1970, where Arthur Corbett attempted to annul his marriage to April Ashley on the grounds that transsexuals were not recognised in English law. It was decided that, for the purposes of marriage, a post-operative transsexual was considered to be of the sex they had at birth.

This set the precedent for the coming decades. People who thought they had existing valid marriages turned out not to - and the previous unofficial changing of birth certificates was stopped.

Transsexual people were able to change their names freely; to get passports and driving licences altered; to have their National Insurance details changed; and so forth. A piece of legislation was also introduced to ban discrimination against transsexual people for employment.

In the 1980s and 1990s the pressure group, Press for Change, helped people take several cases to the European Court of Human Rights about this. In Rees vs. United Kingdom, 1986, it was decided that the UK was not violating any human rights; but, that they should keep the situation under review. The UK government did nothing to look at the situation - and in 2002 in the case Goodwin vs. United Kingdom, it was decided that the rights to privacy and family life were being infringed.

In response to its obligation, Parliament passed the Gender Recognition Act 2004, which effectively granted full legal recognition for transsexual people.

In contrast to systems elsewhere in the world, the Gender Recognition process will not require applicants to be post-operative. They need only demonstrate that they have suffered gender dysphoria, have lived in the 'acquired gender' for two years, and intend to continue doing so until death.

Medical treatment
It has been established by the courts that no National Health Service Health Authority has the right to deny treatment for gender dysphoria as a matter of policy. However, effective access to treatment varies wildly depending upon the policies of the individual Gender Identity Clinics - with some taking a more relaxed approach than others. Transsexual people frequently characterise some centres as arrogant and controlling. A minimum requirement of 24 months real life experience, before a surgical referral is permitted, is not uncommon; and many GICs will force patients to transition before they are allowed access to hormone replacement therapy.

A common alternative for the more well off is to seek private treatment; though most private health insurance plans specifically exclude it. Often, people will seek hormone therapy privately and then later seek surgery on the NHS; which, may prove troublesome because the NHS likes to be involved at all stages of the process.

However, that position has now seemingly been overridden by a subsequent decision, Goodwin v. United Kingdom (11 July 2002) in which the right to marry (Article 12 of the ECHR) and the right to a private and family life (Article 8 ECHR) were infringed by the UK's refusal to allow a post-operative transsexual person to change the gender on their birth certificate (the only conclusive documentary proof of gender in most cases including marriage). One of the factors considered by the Court was the acceptance of gender identity disorder by the UK's National Health Service and the provision of treatment including surgery. Another factor was the fact that the government had effectively done nothing to keep the law under review. The UK must therefore take steps to provide such recognition. In 2004 Parliament implemented its obligation with the Gender Recognition Act 2004.

Corbett v. Corbett
Corbett v. Corbett concerned a postoperative male-to-female transsexual, April Ashley. Ormord J found that since Ashley had male gonads, genitalia and chromosomes at birth, her "true sex" was male at the time of her birth, and that her "true sex" could not be changed. Chisholm attacked Ormord J's argument as simply defining one's "true sex" as ones biological sex at birth, ignoring the social and psychological aspects of sexual identity, without producing any convincing reason as to why these should be ignored. Ormord J mostly presumes it to be "obvious", although he does produce some arguments. He argues that a post-operative transsexual cannot "naturally" perform the "essential role" of a man or woman in a marriage. Chisholm rejects this argument, on the grounds that, whatever exactly the "essential role" in marriage is, be it reproduction or intercourse, many born men or women are incapable of doing so, and yet they are still considered men or women for the purposes of the law of marriage.

Justice Chisholm attacks Ormord J's decision for assuming that there is some essential characteristic that makes people male or female. He argues that sex is a compound of many elements, chromosomal, genital, gonadal, psychological and social, and that while in most people these criteria are congruent, in others they are not. He denies there is any 'true sex' of an individual, beyond these various criteria that make up one's sex, and he denies that any one of these criteria can be taken as totally determinative, in the absence of the other criteria.

Justice Chisholm also notes that while the English, South African and Canadian courts have accepted Ormord J's decision, New Zealand has rejected it. The question had not been considered before by Australian courts.

Justice Chisholm also considers the situation raised by Ormord J, where a married person seeks to changes their sex in the marriage, thereby giving the appearance of a homosexual marriage. Ormord J sees this as an argument against permitting legal recognition of transsexuality for the purposes of marriage law. Justice Chisholm points out that refusal of such legal recognition could equally give the appearance of homosexual marriage, since then someone who appears to be a man and lives socially as a man, but is legally considered to be a woman, could legally marry a man. Justice Chisholm suggests that the person's sex at the time of the marriage determines whether they can legally marry, and that a person who had a sex reassignment during their marriage would continue to be married until either party sought a divorce, even though their marriage would now be homosexual.

IMPORTANT LEGAL NOTICE - The source of this judgment is the web site of the Court of Justice of the European Communities. The information in this database has been provided free of charge and is subject to a Court of Justice of the European Communities disclaimer and a copyright notice. This electronic version is not authentic and is subject to amendment.

Relevant Sections of EMPLOYMENT LAW DESCRIMINATION AT WORK as applicable to the EHRC are contained in the link below and articles of offence

Judgment of the Court of 30 April 1996.
P v S and Cornwall County Council.
Reference for a preliminary ruling: Industrial Tribunal, Truro - United Kingdom.
Equal treatment for men and women - Dismissal of a transsexual.
Case C-13/94.


24 It follows from the foregoing that the reply to the questions referred by the Industrial Tribunal must be that, in view of the objective pursued by the directive, Article 5(1) of the directive precludes dismissal of a transsexual for a reason related to a gender reassignment.

Costs
25 The costs incurred by the United Kingdom and the Commission of the European Communities, which have submitted observations to the Court, are not recoverable. Since these proceedings are, for the parties to the main proceedings, a step in the proceedings pending before the national court, the decision on costs is a matter for that court.

On those grounds,
THE COURT,
in answer to the questions referred to it by the Industrial Tribunal, Truro, by order of 11 January 1994, hereby rules:
In view of the objective pursued by Council Directive 76/207/EEC of 9 February 1976 on the implementation of the principle of equal treatment for men and women as regards access to employment, vocational training and promotion, and working conditions, Article 5(1) of the directive precludes dismissal of a transsexual for a reason related to a gender reassignment.


http://sixthformlaw.info/[...]v_s.htm For the full case transcript and court reports

HOW IT USED TO BE prior to the Gender Recognition Act


Thursday, July 30, 1998 UK


UK

Transsexuals lose court battle

Rachel Horsham (right) says she has been forced into exile

Two transsexuals who accused the UK government of breaching their human rights have narrowly lost a legal challenge at the European Court of Human Rights.
Although Kristina Sheffield and Rachel Horsham live as women after having sex change operations, the law treats them as men.

They argued that the government's refusal to allow them to alter their birth certificates infringed their right to respect for private life, guaranteed by the Human Rights Convention.

But the European Court rejected their case, stating that a birth certificate cannot be amended because it is a record of events at birth and is therefore not affected by subsequent events.



Kristina Sheffield: Not seen her daughter for 12 years
Earlier this year, judges in Strasbourg heard that Londoner Miss Sheffield, 52, had been provided with a passport and driving licence in her new name since changing sex in 1986, but continued to be regarded as a man in the eyes of the law.

Her ex-wife's application to a court to terminate Kristina's access to her own daughter was approved - because contact with a transsexual would not be in the child's interests.

The judges were told that as a result Miss Sheffield has not seen her daughter for more than 12 years.

Ms Horsham, also 52, has been living in Amsterdam since 1974. She claims she was forced to live in exile because only by moving out of the UK to a more liberal regime could she marry her male partner.

She applied for naturalisation for Dutch citizenship in 1992 while still retaining her British citizenship. It was granted in 1993.

A request to amend her birth certificate had earlier been turned down by the UK Office of Population Censuses and Surveys.

Ms Horsham said that Dutch law recognises transsexuality. After sex change treatment, the birth certificate is amended and the individual has the rights of a person of the new sex.

Janis in which case in particular/

The last case I quoted, basically, The two appealed to the High court to change their gender officially,eventually turning to the European rights court, again they lost. which was the norm prior to the case in 2002 after the EHRC brought out its own gender recognition laws in 1999 In 2002 The european courts ruled the UK who had signed up to the charter affecting human rights act was in breach of the charter in the case of allowing transgendered people to have their gender changed on their birth certificates, which prior to the Gender recognition act coming into force in 2005, meant that UK male to female were always regarded in law as primarly that of their birth gender, men. which meant they could'nt marry persons of the same gender ie, men. Prior to the Case of April Ashleys marriage anullment, there was in place an unoficial policy of allowing transgender post ops to have their birth certificates ammended. In this particular case the judge ruled that birth certificates were correct at the time of birth, therefore April was a man and ruled that birth certificates could and should not be altered. Instead of granting a decree absolute regarding the petition for divorce the judge anulled the marriage on the basis it was an illegal marriage, between same sex partners, stating that April could not concieve or was not clinically a female, as her vagina was an artificially constructed one . Now that we can apply to the gender recognition panel and get our gender changed on a birth certificate, we can now legally marry, and assume the benefiets regarding pensions, being located in womens prisons etc.

Rape of transsexual woman stirs legal debate
Last updated: 8/27/2010 7:25


The rape of a transgender woman in the north-central province of Quang Binh has sparked a serious debate among legal professionals after judicial authorities declined to prosecute the three perpetrators.

The German Press Agency dpa quoted officials in the province as saying the victim had not reclassified her legal gender from male to female on Wednesday, August 25. Because Vietnamese law only applies to the rape of women by men, the case could not be prosecuted, they said.

“The laws don’t regulate how to deal with this case, so even if the group raped her ten times, we would not be able to sentence them,” Nguyen Van Thin, chief judge of the provincial People’s Court, told dpa.

According to Ho Chi Minh City Law newspaper, the unidentified woman was gang-raped by the three men on April 4. She reported the crime to local police the following day. After the men were arrested, they confessed to the crime in custody.

The province ran into problems when the authorities found that all of the victim’s identification documents indicated her gender as male.

She said she had undergone a sex change operation overseas four years ago and now, as a woman, she insisted the rapists be punished, the newspaper said.

Some experts said, legally speaking, the victim is still a man and the case is thus not covered under the law. They said that Vietnamese law does not recognize the grievances of transsgender rape victims.

Other legal professionals did not agree. They said the law only stipulates that “those who use force, threaten to use force, or abuse the defenselessness of their victims, or use other tricks in order to have sexual intercourse with the victims against their will” are guilty of rape.

Because the regulation makes no reference to the genders of either the offender or the victim, anyone who commits the crime can be prosecuted under current law.

Judge Pham Cong Hung, from the HCMC People’s Supreme Court, said that what the three men did to the victim was enough to hold them guilty of rape and there should be no question about it.

Hung also believed that the victim should be treated as a woman.

Any thoughts comments,? bears some similarities with my opening, example of the definition of what constitutes a legal vagina. here it would also appear that the offence of rape is not gender specific. here in the UK now its a section one offence under the sexual ofences act, a crime against the person (none gender specific]. includes vaginal rape or anal rape.