Christina Ketcham
Christina Ketcham

Oregon, US – A man who had previously undergone hormone replacement therapy, gender-affirming surgery and voice feminization lessons has secured the legal aide of the National Center for Lesbian Rights in a $375,000 lawsuit against his health insurance companies and employer after he was denied coverage for facial feminization surgery.

59-year-old Christina Ketcham says his doctors recommend he undergo such procedures as a rhinoplasty, facial bone reduction, face lift, and an eyelid lift in order to ease the “gender dysphoria” he has felt since childhood. The procedures could cost as much as $20,000 to $40,000.

Over the past three years, Mr Ketcham, a fisheries biological aide for Clatsop County, has repeatedly requested coverage of facial feminization surgery from Citycounty Insurance Services, which provides health coverage to county employees, and Regence BlueCross Blue Shield of Oregon, which administers the health plan. Deeming the facial work “not medically necessary,” the insurance companies have refused to cover the procedures.

On July 18, Mr Ketcham filed a $375,000 lawsuit against the insurance companies and employer in the Multnomah County Circuit Court.

According to the complaint, his inability to attain facial feminization has caused him to suffer ongoing distress, particularly when others clock him as male. “Ms Ketcham continues to be perceived by others as male,” he argues in court filings. “Her facial features and the shape of her face frequently lead others to call Ms Ketcham ‘sir,’ ‘mister’ or ‘he-she,’ and to treat her as a man.”

The plaintiff’s lawsuit alleges that Regence BlueCross Blue Shield is discriminating against him and other transgender persons by refusing to deem facial feminization surgery medically necessary and provide coverage for it. The World Professional Association for Transgender Health has declared that facial feminization surgery and other gender-affirming surgeries are not “cosmetic or “elective,” the lawsuit notes.

Asaf Orr
Asaf Orr, a staff attorney for the National Center for Lesbian Rights, is one of the lawyers representing Christina Ketcham in his anti-discrimination lawsuit.

Asaf Orr, Transgender Youth Project staff attorney for the National Center for Lesbian Rights in San Francisco, is one of several lawyers representing Mr Ketcham. Mr Orr, who identifies as a heterosexual, “cisgender” male, has passionately devoted his life to the fight for transgender causes, once declaring transgender youth “heroes” who taught him “what courage and perseverance look like.”

Mr Orr said that a suit like Mr Ketcham’s has become rare now that gender-affirming procedures are covered by most insurance plans. The last legal demand for gender-affirming surgery the National Center for Lesbian Rights was involved in was in early 2018, when the organization successfully fought for Oregon Health Plan to cover the facial feminization surgery of another male plaintiff.

Employment Litigation Attorneys Talia Guerriero and Christina Stephenson of the Meyer Stephenson firm in Portland are also representing Mr Ketcham in the lawsuit.

Read more on this story

In rare lawsuit, Oregon transgender woman sues insurance companies to pay for facial surgery
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.

Oregon transgender woman sues to have her insurance pay for facial surgery
A transgender woman in Oregon has filed a $375,000 lawsuit against her insurance provider and her employer, alleging they discriminated against her by refusing to pay for facial surgery that would make others perceive her as female.

This lawyer fights for his ‘heroes’ — transgender youth
The Jewish News of North Carolina
You describe yourself as a cisgender male — meaning that your gender identity corresponds to your birth sex — and as heterosexual in orientation.


  1. Facially, this man could already pass for a 59-year-old woman. (I’m female, 59, and live in a senior community. His face could pass even though his body is obviously male.) Sounds to me like he wants to look like his favorite 19-year-old porn star. Yeah, let’s pay for this guy to try to look like a young woman, but keep on denying new mothers overnight postpartum hospital care and fat people joint replacements. The SELFISHNESS of these men is amazing.


Leave a Reply (Subject to Moderation)