Facts: Ms van Kuck was a transsexual, who had been born male but had changed her forename to a woman’s name and received hormone treatment; she now applied for funding for gender re-assignment surgery, from her insurance company, which refused to pay. The German courts heard expert evidence, which recommended surgery, but had nonetheless concluded that she had a disease which it was appropriate to endeavour to cure through psychotherapy.

Judgment: the German courts had failed to properly understand and taken into account the medical evidence, rendering the trial incompatible with Article 6 ECHR and the refusal to surgery incompatible with Article 8 ECHR, in that a fair balance had not been struck between the interests of Ms van Kuck and the German insurance company.