A transsexual has lost an Appeal Court battle in her bid to obtain NHS funding for a breast enlargement operation.
The 59-year-old, referred to as "C", who suffers from gender identity dysphoria (GID) and cannot be named for legal reasons, had challenged a decision by West Berkshire Primary Care Trust (PCT) not to provide the money.
But three appeal judges ruled that the decision was one the PCT was entitled to reach and not irrational.
C, who lives in the Reading area, was born male but has been living as a woman for more than a decade.
Despite hormone treatment which began in 1996, her breasts have failed to develop to a size "appropriate to her size and frame", her lawyers said, leaving her feeling that she has not completed her transition from male to female and is now in physical and psychological "limbo".
C's lawyers had asked the Court of Appeal at a hearing earlier this month to overturn a High Court ruling in May last year that she was not entitled to funding for surgery to increase her bust - expected to cost some £2,300 - as part of her medical treatment for GID.
She described facing "abuse and hostility" in public because she was still not seen as a woman. She said youths had called her "all kinds of names".
Her lawyers argued that having breasts was, in C's case, "clearly an important aspect of successful re-assignment to the opposite sex".
Lawyers for the PCT said surgery was not an essential part of GID treatment and there was no good evidence that it would be cost-effective or clinically effective in C's case.
On Friday, Master of the Rolls Lord Neuberger, sitting in the Court of Appeal with Lord Justice Sedley and Lord Justice Hooper, upheld a decision of High Court judge Mr Justice Bean which backed the PCT's stance, saying Mr Justice Bean's ruling was "unassailable".