Some people stock away their entire life savings to buy a home or to save for retirement, others do this for what they feel is rightfully theirs — a sex change.

Until recently, anyone claiming to be the opposite gender faced abuse, ridicule, and even retention in psychiatric hospitals. But studies in the last decade suggest that when a child is born, it may not be what it seems.

“A baby girl may already have the emotions and feelings of a boy,” John Illman writes in Health magazine.

The transition from one sex to the other is not easy, and not cheap either.

Costs not only include sexual reconstructive surgery, but a wide range of health services and treatments including hormone supplements, psychotherapy, and electrolysis to remove unwanted hair. Depending on the procedures involved, sex reassignment surgeries in North America can cost from $5,000 to $100,000. Most medical procedures related to transgender care are routinely excluded from nearly all health insurance plans.

Costs to continue living also add up. Legally changing one’s name and gender identity on all legal documentation and buying a new wardrobe in that gender gets pricey, almost unmanageable.

According to Transexual Road Map, a resource center for trans individuals, in order to change one’s name and sex on a valid passport, one’s social security card and/or birth certificate, one needs a court-ordered name change and a notarized letter from their surgeon showing they have had sex reassignment surgery. This may vary by state.

So in order to fully change one’s gender identity legally, sex reassignment surgery is a must.

So why isn’t a sex change tax-deductible, and why aren’t all insurance plans helping cover these costs?

“It’s absolutely clear that transgender identity is a condition discussed in diagnostic manuals,” Marshall Forstein, a Harvard Med professor, told the Washington Post last October.

The most debatable case still being discussed today is that of construction worker Rhiannon O’Donnabhain. In 2001 this transwoman had a sex-change operation that cost her up to $25,000. When she asked for a $5,000 deductible the Internal Revenue Service (IRS) issued her a refund check, only to have her return it shortly after. According to the Washington Post, the IRS determined her surgery was merely “cosmetic” and therefore not tax-deductible.

“When did the IRS suddenly become physicians?” Forstein said to the Washington Post. “It seems the IRS is now in the business of practicing medicine without a license.”

How can the IRS not offer some sort of refund check for an operation that is necessary for legal and living purposes? If the government is not willing to accept one’s gender change without a surgeon’s signature to prove the reconstruction of their physical parts, how can the government not offer any aid to those following the rules?

According to an IRS publication, deductible medical expenses are, “costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or functioning of the body … [to] primarily alleviate or prevent a physical or mental defect or illness.”

How is it that abortions, vasectomies and even bunions on one’s feet can be covered, but not gender identity disorder and sex change?

With debates and lawsuits occurring over this topic world wide, we must stand together to lead the progressive fight for our laws and freedom to live and be. If we do not, then it appears we will remain at the mercy of those who do not accept that all people have needs. Transgender individuals have needs, and if these lawmakers are not listening to the physicians and researchers proving them wrong, then who will they listen to?