A $25,000 tax deduction claimed by a Boston man in 2001 for Plastic Surgery to feminize him has been disallowed and is being played out in Federal Tax Court next week. Rhiannon O'Donnabhain is suing the IRS in a case advocates for the transgendered are hoping will force the government to treat sex-change surgery the same as appendectomies, heart bypasses and other deductible medical procedures.

Activists argue that because gender-identity disorder is a recognized disorder in the medical literature, the costs are therefore legitimate medical deductions. This is a patently ridiculous assertion, which looks even more ridiculous in the context of a health care system that is going bankrupt.

Most reasonable people are going to be sympathetic to the psychopathology of transgender individuals, but asking them to subsidize their cosmetic surgery (it is not reconstructive surgery) to self-actualize their body image/identity issue is DOA. The IRS says cosmetic surgery or similar procedures are deductible only when they are needed to improve a congenital abnormality, an accident or trauma, or a disfiguring disease. I wrote a post on the history of plastic surgery and tax deductions last fall here

As many as 2,000 sex change operations are done annually in the United States which can include components such as mastectomy (removal of the breast), feminizing of the face, castration, turning a penis into something resembling female genitalia, and everything in between.

If you want to see some very interesting (but graphic) photos of the surgery for this you can go here and scroll down. The creativity of these kinds of procedures and the skill of the surgeons is really without question. Unfortunately, the number of doctors who do these is dwindling as it's kind of been marginalized as a real small niche within both Plastic Surgery and Urology. Ironically, there's real good money in this area because there's so few doing it and they can charge premium fees for their surgical services. In an era where we're making tough decisions re. what we can and can't afford with health care, I have no problem expecting people to finance these operations themselves.



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