MEDICAL NEEDS

IRS Agrees To Exempt Some Sex Reassignment Surgeries (Except For Boob Jobs)

From the time she was 10, Rhiannon O’Donnabhain felt uncomfortable with her biological gender. As an adolescent she secretly dressed up in women’s clothes and as an adult she tried marrying a woman. But though she fathered three children, something still didn’t feel right. So she eventually divorced and underwent about $5,000 worth of sex reassignment surgery.

But when she tried to deduct the surgery costs from her taxes, the IRS denied her, saying the procedure was entirely “cosmetic.” So in 2006 she sued. And this week a Tax Court found in her favor… well, mostly in her favor anyway.

O’Donnabhain’s 2006 lawsuit called her surgery necessary for “a serious medical condition.” And the U.S. Tax Court’s decision agreed with her. As a result, the IRS acquiesced to exempt such procedures from taxation henceforth.

And while that’s awesome news for the thousands of transgender people who opt to undergo reassignment surgery, two things stick out about the decision:

1) The court did not exempt O’Donnabhain’s breast augmentation surgery because, “it was directed at improving her appearance and not to treat disease as construed by the tax code.” Even though the court did not rule out the possibility of exempting chest surgeries in the future, it’s interesting that they don’t see the necessity of breast augmentation towards bringing one’s body in line with their perceived gender. Would they have considered a mastectomy for a FTM trans person “cosmetic” as well?

2) The decision still reeked of transphobia. University of Pittsburgh law professor Anthony Infanti called some of the wording in the court’s dissenting opinion “clearly hostile to the taxpayer.” Even Judge Mark V. Holmes’s decision in favor of O’Donnabhain said that the decision put tax courts “into culture wars in which tax lawyers have heretofore claimed noncombatant status.”

Whether you like the official medical diagnosis or not, O’Donnabhain was able to claim exemption because her surgeries helped treat “Gender Identification Disorder”, a psychological diagnosis that pathologizes transgender identity and seeks to “cure” it the same way some ex-gay therapies seek to “cure” homosexuality. While transgender people don’t see their identity as a mental pathology, they do want the medial community to recognize the necessity of reassignment surgeries for a trans person’s ability to live and function well in life.

It’s great though that the U.S. Tax Court’s decision brings the trans community one important step closer towards having corporate insurers, medical professionals and the greater government recognize that necessity of and eventually create a minimum basis of medical care that should be afforded for all trans citizens.