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Katia (2004). August-Spain The Social Services Division of the Appeals Court of Madrid ruled against the Madrid Institute of Health (IMSALUD) and for the first time in Spain made health serives responsible for funding sex reassignment surgery involving vaginoplasty. The facts date back to March of 2000, when "Katia" reported to the hospital in Madrid to initiate the sex reassignment procedure. After several consultations, analyses and other tests . . . , she requested vaginoplasty at a private clinic which was part of the public health system, at which point the IMSALUD replied that this surgery was not covered except in cases of pathological intersex conditions. The Court accepted as proven that "Katia" presented with permanent signs of belonging to the female gender . . . and was "profoundly affected with an intersex condition, and that the guidelines require that sex reassignment surgery be paid by Social Security" when correcting intersex conditions. The Court determined that this wass the condition which Katia had. Previous cases in Spain had failed, specifically, because the transsexual individuals concerned were diagnosed with a gender identity problem, not an intersex condition. Katia's case established an important precedent.
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