The case is the first time sex change operations have been fully tested in an open court and the ruling paves the way for other transsexuals to fight for sex changes on the NHS.
The hearing at the High Court in London saw three transsexuals challenge North West Lancashire Health Authority's decision not to pay for operations, costing between pounds 7,000 and pounds 9,000 each, which medical specialists say are vital to complete their physical male-to-female transformation.
Mr Justice Hidden ruled that the decision was "unlawful and irrational" and had been taken without consideration of what was "the proper treatment of a recognised illness".
"Miss A", aged 21, "Miss D" and "Miss G", both aged 50, were turned down for gender reassignment surgery in 1996 and 1997 after it was decided none of them had shown a demonstrable "overriding clinical need" for treatment.
The health authority, which covers Blackpool and Preston, said it was entitled to take into account its own "scarce resources" and refuse funding.
The judge ruled it was not entitled to operate any policy that interfered with its duty to provide treatment "for the prevention of illness and care of persons suffering from an illness".
Later Stephen Lodge, solicitor for the three, said: "This is an important test case. We have successfully settled a number of previous cases, but this is the first time the issue has been fully considered by the court and we are delighted with the decision.
"Other health authorities will now have to assess whether their policies for the treatment of transsexuals are lawful in the light of this judgment. We hope it will be easier for transsexuals to obtain the treatment they so clearly need, and that it will help to alleviate the present injustice of arbitrary and unequal treatment by postcode."
Miss A, who was in court, said: "I am not surprised. It is the end of two years of hard work in fighting this legal battle. They should not have discriminated by postcode."
Miss A said: "This legal battle has cost at least pounds 47,000 - enough to pay for several operations."
Gerard Clarke, for the health authority, asked for leave to appeal, saying it was the first case of its kind. He added: "This is a matter which concerns not only this particular authority but many other authorities. This is going to be a matter of considerable importance throughout the health service."
During the recent hearing he told the court there was appropriate alternative treatment available for transsexuals - those suffering from gender identity disorder - in the form of psychotherapy to reconcile them with their biological nature.
Nicholas Blake QC and Stephanie Harrison, appearing for the three applicants, said health chiefs had misunderstood the nature of the illness. It was not, as they seemed to think, on a par with "body image" cases, such as weight reduction, tattoo removal or operations to reduce the size of breasts or noses for cosmetic reasons.
The lawyers accused the authority of applying, since March 1995, an unlawful blanket policy of not funding gender re- assignment treatment.Reuse content