A patient, a transsexual suffering from gender identity who wanted a sex change operation, sought a writ of mandate to direct respondent director to grant the treatment authorization request for appellant’s surgery in order for the Medi-Cal program to pay for the procedure. The lower court refused to grant the writ, and the court reversed. The court held that all of the evidence presented showed that the surgery was necessary and reasonable, and respondent could not arbitrarily classify the procedure as cosmetic. The court found that as this classification was the sole basis for respondent’s decision, his decision must be set aside. The court reversed the judgment, and remanded the case for the lower court to issue the writ of mandate directing respondent to grant the authorization request.