The first United States case involving a private health carrier and reimbursement for sex reassignment surgery was decided by the New York Supreme Court in 1979. Victoria Davidson’s insurance carrier, Aetna Life Insurance Company, refused to bear the cost of medical expenses for SRS, alleging: 1.) Gender dysphoria is not an injury; 2.) Transsexual surgery is cosmetic in nature; 3.) Surgical intervention is not necessary and unreasonable. The court ruled in favor of Davidson, finding the surgery “cannot be considered to be of a strictly cosmetic nature”, and that the “sex change operation of the plaintiff is of a medical nature and is feasible and required for the health and well-being of the plaintiff”.