A court has ruled that the city of New York must pay for gender re-assignment surgery for a 21-year-old.

Mariah Lopez was in the care of the city when she began her legal fight to get treatment. The Manhattan Family Court was told that Ms Lopez’s surgery would cost $15,000 to $20,000.

Judge Sheldon Rand’s judgement read:

“Mariah L. should be treated in order that she may go on with her life and be in a body which blends with the gender with which she identifies.

“This court has recognised that gender-identity disorder is a real condition and there is a real solution to it and people don’t have to suffer from it,” according to the New York Post.

The judge accepted that surgery is the appropriate treatment, and that the city must provide all the necessary care for children in its care.

“I don’t think it’s hit me yet. The consequences are so far reaching,” Mariah Lopez told the Post.

The city is planning to appeal. It is the second time that the city has been ordered to pay for Ms Lopez’s surgery.

She was taken into care at the age of 6, and has been taking hormone treatment since the age of 15.