Noah is a young transgender man living in Seattle. He has long known that he is male, even though he was assigned a different sex at birth. At the recommendation of his health care providers, Noah had chest reconstruction surgery to affirm his gender at age 17.

Noah’s mother, Maggie, has health insurance for their family from Group Health. She sought authorization for insurance coverage of the surgery, but her request was denied on the grounds that Noah had not yet turned 18.

Maggie and her husband saw how important and urgent the gender-affirming surgery was for their son. “It was impossible to live as a 17-year-old senior male with very large breasts,” Maggie said. “For many months he barely left his room and didn’t see his friends anymore.”

So they paid for the surgery out-of-pocket, using credit cards to pay the medical bills that Group Health refused to cover.

We are awestruck by how Noah’s parents supported their son. But we are outraged that they were forced to support him in this way. Group Health never should have denied coverage for this surgery. The standards of care for transgender patients clearly state that chest surgery can be medically necessary care for minors, and all of Noah’s health care provides agreed that the surgery necessary.

Legal Voice intervened on behalf of Noah and his family, requesting an independent, external review of the denial of coverage. After only 10 days, the reviewer issued a decision that overturned Group Health’s denial of coverage, saying that Noah “has well documented gender dysphoria and has the capacity to make an informed decision.”

Noah and his parents are absolutely thrilled with this decision. And so are we! Our advocacy for Noah brings us one step closer to health care parity for all.