The Double-edge sword

It was announced this week a woman in Massachusetts won her case with the IRS in the US Tax Court. She filed her income tax statement deducting $5,000 for her sex reassignment surgery and other related expenses associated with her treatment for "Gender Identity Disorder", the term used in the DSM-IVTR for treating patient who are diagnosed with the identity opposite their birth sex.

The medical procedures are well defined in the Standard of Care under WPATH's oversight formerly the HBIGDA and endorsed by both APA's (psychological and psychiatric associations) in the DSM. Ok, seem straight-forward, except the IRS has routinely denied anyone the deductions on the patients taxes, even though the majority of health insurance companies refuse to cover the costs (considered cosmetic or elective surgery, depsite the medical evidence to the contrary).

This time the person won. The surgery, almost always paid out of the person's pocket (except those who sell their stories for TV news documentaries where the TV station usually picks up most if not all of the cost, which runs $20-25K). A few employers now pay some to most of the expenses for permanent employees under their health coverage (after the health insurance coverage).

That's cool, huh? Well, sorta', as someone may say. While many transpeople advocate for removal of GID from the DSM, called the depatholization, and some called for a new name as a condition, both of these would provide the avenue to deny or reject coverage for the therapy, hormones and surgeries necessary for a sex change (often called sex transformation now in the insurance handbooks).

That's the double edge sword. This decision opens the door to mandate coverage by insurance companies to cover a disorder defined in the DSM. Almost every other disorder or disease is covered to some extent. GID isn't to any extent. But to push for coverage, the name and label would persist. The patient would be diagnosed with a recognized disorder and open to a treatment plan with a "cure" including SRS.

The problem is that few, if any, transpeople call or consider themselves "sick" in need of a cure. It's a simply birth defect (wrong physical sex) than a mental disorder. This is in part what Alice Kalafarski makes in her essay at Bilerco. Unfortunately I think she misses a point.

While I agree with her view on the matter of being trans or having GID, I think she misses the point about the tax dedcution. It's easy for those who can afford SRS or those young enough to go in debt ot pay it off later. But the vast majority do need the tax deduction as the cost is prohibitively expensive, causing great financial sacrifice to the woman.

And for that, having a disorder and be "cured" is only temporary to getting the tax deduction. You can forget the label in time, but you may not be able to recoup the lost money. It's a trade-off each transwoman should have the right to choose than facing no choice.

And I don't agree it's about rights of transpeople over the rights of the individual transperson. I'll take the individual's rights any day. It's easy for those who have the freedom, and usually have finished their transistion, to forget others and their rights and often their problems to transistion, where money is almost always the overriding issue.

We shouldn't forget to fight for the medical community and especially the insurance companies to do what is best for the patient, provide the treatment for transpeople so they can affordably transistion and get on with their life and work as they know themselves to be. That's the priority, the everything else is later.