Men cannot automatically have their so-called man boobs reduced at the expense of their health insurance. Breast swelling (gynecomastia) in men is usually “not a disease that requires treatment,” the Hessian State Social Court announced on Tuesday.
The surgical removal of breast tissue (mastectomy) is therefore not automatically covered by statutory health insurance. This was the ruling of the 1st Senate of the court after a man filed a lawsuit.
The 52-year-old wanted his insurance to pay for a bilateral breast reduction. According to the court, he cited sensitivity to touch and pain as well as psychological stress. However, the statutory health insurance company rejected the operation as medically unnecessary. The judges agreed, because not every physical irregularity is a medical condition.
Every second person has man boobs
Surgical breast reduction should only be “a last resort,” the court said. However, if an operation involves intervention in a functionally intact organ, a specific justification is required. Moreover, breast swelling occurs in more than half of all adult men.
From the perspective of the judiciary, the insured person has not been proven to have suffered from orthopedic or dermatological complaints due to gynecomastia. The occasional use of freely available painkillers is also not valid evidence of particularly severe pain – presumably caused by breast growth. Psychiatric and psychotherapeutic treatments could be considered for any psychological stress.
Clothing should help those affected, according to the court
An illness only exists if a person’s bodily functions are impaired or if a physical abnormality has a disfiguring effect. In the judges’ view, the physical characteristic of the man from Hesse was not so severe that it would regularly lead to him being restrained by other people in everyday situations.
The court told the man that he could help himself by wearing appropriate clothing: “Unclothed, gynecomastia does not appear obviously repulsive.” An appeal was not allowed. (KNA)
