Jessiah MacDonald, 24, told the Canadian Broadcasting Corp. Nova Scotia's Medical Services Insurance billed him because it considered the hysterectomy to be sexual reassignment surgery, which it doesn't cover.
He said he had the operation in 2010, but was never told he could be charged for it.
"I felt it was wrong because, despite my gender, I still have pieces of my body and if a piece of my body gets sick, I expect it to be treated as any other piece," he said.
MacDonald, born Jessica MacDonald, said medical problems arose after he began taking testosterone when he was 18.
He said he went to a gynecologist after experiencing abdominal pain.
"The gynecologist had mentioned during the consult that I had a small uterus and she could feel multiple polyps during the internal exam, and that was sufficient enough for her to suggest a hysterectomy. But there was no mention then that it was only if I was female. There was no mention in the nine months between that and the surgery date," he said. "The gynecologist said I had two options to deal with the symptoms I was having. The first would be to take birth control to raise my estrogen levels but she ruled that out as an option because I take testosterone. I'm a man. And the second option was the abdominal hysterectomy, which was her suggestion."
After learning he was being billed for the operation, MacDonald hired lawyer Kathryn Dumke, who is also transgender, and filed his complaint against MSI.
"I have never heard and I don't think anybody has ever heard of a case where a condition needed treatment and the treatment was denied because MSI questioned that it wasn't medically necessary," Dumke said.
MacDonald is seeking to have his bill covered and for MSI to change its policy so transgender people can have a hysterectomy if medically necessary.