Summary: The case involves K.S., a non-binary individual, seeking Ontario Health Insurance Plan (OHIP) funding for a vaginoplasty without a penectomy—a procedure not typically listed in OHIP’s Schedule of Benefits. K.S.'s request was initially denied by OHIP, stating it was not a standard insured service. However, the Health Services Appeal and Review Board overturned this decision, leading to OHIP's appeal.

Key Points:

• Issue: Whether vaginoplasty without penectomy should be funded by OHIP.
• OHIP's Argument: The procedure isn't listed as an insured service, it's experimental, and not generally accepted by Ontario's medical profession, thus should not qualify for funding.
• Court's Ruling: The Divisional Court dismissed OHIP’s appeal, affirming the Board's decision that the procedure qualifies for funding under the existing healthcare regulations. The court noted that the definition of medical services should be interpreted in line with evolving medical standards and individualized healthcare needs.
• Legal Impact: The ruling emphasizes adapting healthcare coverage to reflect modern medical practices and the specific health needs of individuals, particularly in the context of transgender healthcare.

Outcome: The appeal by OHIP was dismissed. The court supported the broader, inclusive interpretation of insured services to accommodate procedures like K.S.'s, stressing the importance of tailored healthcare provisions. Costs of $20,000 were awarded to K.S.