Thursday, May 9, 2013

Social Security Administration Recognizes Transgender Woman’s Marriage

Transgender Law Center recently helped JoAnna obtain recognition of her marriage by the Social Security Administration.  JoAnna married many years ago before her gender transition.  Last February, JoAnna approached her local Social Security Administration office with paperwork necessary to designate her spouse as her beneficiary for Medicare and retirement benefits. However, the clerk in the SSA office refused to process JoAnna’s paperwork until her spouse was removed, stating (incorrectly) that their marriage was not recognized by the federal government. Under the laws of every state, a marriage that is different-sex and valid at the time it is entered into remains valid even if one spouse transitions.
The only ways to terminate a marriage under California state law are death, divorce, or annulment. It is the policy of federal agencies to recognize any marriage that was valid and different-sex in the state where the marriage took place at the time it was entered into.  That is, gender transition alone cannot invalidate a marriage.  Transgender Law Center contacted attorneys at the Social Security Administration, who confirmed that the agency would recognize JoAnna’s marriage for the purposes of spousal benefits under Social Security and Medicare.
Get Legal Help: Click here or call 415.865.0176 ext.306
Get E-mail Updates: Click here or text translaw to 22828

on Marriage and Transgender Couples

Many transgender couples want to know what the law is regarding marriage
when one person is transgendered. This isn’t a simple question to answer
because different states have taken different approaches to this issue.
Generally speaking, the law says that the validity of a marriage is determined
by the couple’s status at the time the marriage is performed.

Therefore, as long as a couple was legally entitled to marry when they entered into the
marriage, they remain married until death or divorce. However, currently,
Washington, as well as 48 other states, limits marriage to different-sex couples.
What does this mean for the transgender couple? It means that transgender
individuals are often able to enter into heterosexual marriages after undergoing
sexual reassignment surgery. This also means that if the spouses were of
different genders at the time of their marriage, the marriage should remain
valid even if one spouse later transitions to become the same sex as his or her

Practically speaking, however, the legal validity of a marriage involving a
transgender spouse is an unsettled issue in many states. Although most states
permit a transgender person to marry a person of the other gender, some states
have taken the hard line view that gender is fixed at birth and that reassignment
surgery cannot change that fact. So, for example, a court in Texas invalidated
a 7-year marriage between a transsexual woman and her deceased husband. As
part of a wrongful death suit, the court held that a person’s legal sex is
genetically fixed at birth and that the wife was legally male, despite her female
anatomy and appearance and despite the fact that she had lived as a woman for
most of her life. Tragically, this decision left the wife without any of the rights
or protections of a legal spouse – not only the ability to bring a wrongful death
action, but the right to inherit and to obtain her husband’s social security and
retirement benefits.

Other states have held that marriages involving a transgender spouse are valid.
In California, for example, the courts have legally recognized the postoperative
sex of a transsexual person. It is important to note, however, that in some cases,
courts have required the transgender individual to offer extensive
medical evidence to prove his/her new legal gender. But as long as someone
has fully transitioned and has taken the necessary steps to have his/her new
gender legally recognized, the validity of the marriage should not be

Monday, February 18, 2013

10 Things I Wish I'd Known When I Started My Transition

ARTICLE: Exactly two years ago, I sat apprehensively in the reception area of the public health clinic in San Francisco's Castro neighborhood, waiting for my name to be called. If all went according to plan, I would leave that evening with my first prescriptions for estradiol and spironolactone -- day 1 on hormones. I had just come from work, and because only a handful of my colleagues knew about my transition, I was still presenting as a boy (albeit an androgynous one wearing gold eye shadow). I remember looking around the room at the other trans girls sitting nearby. I couldn't wait to be just like them -- to have people see me as my true gender and to finally start feeling comfortable in my body.

Sunday, December 16, 2012


JUST A PERSONAL NOTE: I plan to leave my Social Security, Medicare, Birth Certificate and IRS filing as Male just to be safe and simple at least until the legal nonsense settles. My wife and I have been married "forever" when I was male so perhaps I am being over-cautious, but I need to be careful for her sake.

Yes. On November 21, 2011, the Internal Revenue Service (IRS) affirmed that transgender people can deduct the costs of hormone therapy and sex reassignment surgery from their gross income as medical expenses for the treatment of gender identity disorder (GID). This announcement indicates that the IRS will follow the United States Tax Court’s 2010 decision in O’Donnabhain v. Commissioner of Internal Revenue that a transgender woman’s medical expenses for hormone therapy and sex reassignment surgery were legitimate treatments for GID and therefore tax-deductible under Federal law. After considering extensive medical evidence and testimony from leading medical experts, the court rejected the IRS’s previous interpretation of the law that considered transgender people’s medical treatment
different than all other medically beneficial treatments.

Breast augmentation surgery is deductible in some cases. The Tax Court made clear that breast augmentation surgery for transgender women is an allowable deduction as long as the taxpayer can show documentation from medical care providers that the surgery was medically indicated for the purpose of by achieving breast development that is not obtainable through hormone therapy.

Yes. Under state marriage laws, the validity of a marriage is determined at the time of marriage. If you were legally an opposite-sex couple when you married, your marital status cannot be invalidated by subsequent events. For the same reason, the federal Defense of Marriage Act does not prohibit federal recognition of married couples in this situation. You should be able to file jointly as a married couple, and are not required to count a spouse’s employer-provided health benefits as taxable income.

Wednesday, October 24, 2012

Trans Legal

This  is complex and varies among states. There are many implications for marriage, health benefits, Selective Service, taxes and I am sure much much. Many change their IDs but not Birth Certificate. I changes my name everywhere, but not sex on my birth certificate or Social Security. It might be better to leave birth certificate sex unchanged. There is more to learn. There are some links in the "Legal" list below.

Wednesday, September 26, 2012

Guidelines for Transgender Care

Transgender Health Program


The Transgender Health Program oversees the development of guidelines for care, with program staff and contracted specialists assisting with review of best practice research and standards developed by other transgender health program

Health Resources from HRC

Here are many many excellent resources for trans people and their families provided by the Human Rights Campaign


Transsexual Road Map

Welcome! Transsexual transition is simply a journey. Just like a trip, you decide on
  • your destination
  • the time you'll need to get there
  • the money you'll spend
Transsexual Road Map is a travel guide to set priorities and choose your route.
It's about making informed purchasing decisions and setting realistic, achievable transition goals.
First time visitors should start here.
This site's 1,600+ pages of FREE original content will always be available at no cost, to help those who can't afford to pay.

Transgender Health Learning Center

Browse our resource inventories to the left, or start with the featured items below.

 From the Center of Excellence for Transgender Health

How to Develop a Female Voice

Melanie Anne Phillips
 I'm a composer, photographer, poet and artist. I have more than 200 credits in film and video and have taught creative writing for novelists and screenwriters since 1991.

Whether you are a crossdresser or transsexual, developing a truly FEMALE voice - not just a feminine one - is of paramount concern. When I began my transition, there was electrolysis to worry about, mannerisms... but it was voice that seemed to me the greatest obstacle.

Like most, I tried simply feminizing my voice, softening the voice I had. I tried raising my pitch artificially, arriving at that bad falsetto that forms the stereotype of the transgendered marking them as parodies rather than the real thing. Eventually I even consider vocal chord surgery as a last resort.

Voice surgery made me nervous though. I had a fairly decent singing voice, I like to do character voices, I liked to sound dramatic when I spoke. But the thought of being read every time I uttered a word was enough to tip the balance to consider voice surgery, even though all end-results I had heard were not very convincing AND I had heard horror stories of those who as a result of the surgery lost their voices completely!

I had just about resigned myself to that risk when, a few months into fulltime, I stumbled into something quite by accident that has made the difference in my career, my relationships, in my life as a whole: I learned to sound female.

Notice I did not say "to talk like a woman", but rather "to sound female". This is because the secret I found is not in the way one speaks but the way one sounds. I had been trying out different voices that day (as I did most days), sometimes trying to sound like a squeaky teenager, other times like a mature matron. For weeks I had been struggling with no progress to speak of. And then, this one day, suddenly something happened. My voice "slipped gears" and came down in a different place than it had ever been.

All at once, in one broad stroke, the TIMBER of my voice had turned female. I couldn't believe it! I actually SOUNDED female! I tried saying this and that and EVERYTHING sounded female. This was incredible! After all my fears and yearnings... well, it was almost like magically being transformed into a woman!

on Name Change

Each state has different laws on name changes so I recommend knowing the issues before you proceed. I live in California and the laws also affect changing the gender on California Birth Certificates. I was not born in California so those did not apply to me, but for California born folk it could require another court appearance and other requirements to change ones gender. Of course another court proceeding may require another legal fee or advertising expense. Many of these laws are changing so get the latest information and understand the inter-relationships between various jurisdictions and documents.

In my case I only needed the judge to approve the name change. I prefer to keep thngs as simple as possible. In my case, "Personal Preference", was legally acceptable as there were no contrary reasons or legal proceedings. The judge asked why I wanted to change my name to "Billie Rene" (typically female) as I was in male dress. I answered, "Personal Preference". He asked what I meant. I replied, "It is my wish" and he granted the change immediately. It was a polite, legally correct and most important, simple reason with little else he could easily begin questioning. 

I suspect he wanted to check if I were California born which at that time possibly involved gender change and another legal filing if done separately. UNDERSTAND YOUR STATE LAWS AND PROCEDURES FIRST to keep your paperwork simpler.

Sunday, September 23, 2012

Passing OR Acceptance... that is the question

Before, passing was important to me, but a funny thing happened along the way; I ceased to care. It seems that most folks like me better as a girl than as a guy. I am happier and in-turn I am better liked. Worries drop away and I relax and just enjoy being me and interacting with others, particularly women.  My voice has improved and some cisgender women have huskier. voices then me. Initially, I was concerned when I got a "Sir" on the phone, but that is not unusual for women with strong alto voices.  I will never sound like a "valley girl" nor would that be appropriate.

Here is Southern California, I suspect that although people notice it makes little difference to them as I present well and smile. In short, I am accepted, and perhaps folks find me interesting.  The encouragement women give me is amazing. It was so unexpected.

There is much to learn and I study carefully. Other advantages that helped are: education, reading speed, and the many books, articles, iTunes podcasts and YouTube videos. My white complexion,  average size and being a fair mimic also help. On occasion someone might look a bit longer as if studying me; I just smile pleasantly and all is well.

It is becoming less important to me to "pass" 100 percent because I am so well accepted. In fact, although my voice has improved, it is becoming less important to me because I am so well accepted. I just enjoy being me and I am very happy that others like me as well. I wish I could have transitioned so much earlier, but society was much different then.

For those who may wish to transition, study carefully and know yourself. It's a huge step and there is lots to learn. Personal experience may vary, and it is not easy in the best of cases. Some communities and families are less accepting. Some people are more friendly and others less. But ignoring my situation proved impossible--it does not go away. It is result of hormone baths prior to birth and they influenced me as powerfully as specifying blue eyes or brown hair. I enjoy being a girl. 

Saturday, September 1, 2012

Former policeman set to return to the force as a woman after undergoing sex change

A former police officer forced out of the job 27 years ago because he wanted a sex change is set to return to frontline duties as a woman. Karen Gale, whose two-a-half-hour operation was controversially broadcast on television last year, has applied to be a special constable and return to the Metropolitan Police.

 The 53-year-old, previously known as Keith, worked as a PC with the Met between 1981 and 1985 before being forced to resign when he told his inspector he wanted to start treatment for gender change. Karen, from Purfleet, Essex, said: 'Back then things were different. My inspector told me there was no way I could stay in the job. 'I was absolutely gutted. I loved my job and I had spent two years passing all my exams to become a constable.'

 But now Karen, who underwent the sex-change operation at Charing Cross Hospital in London in August 2011, is hopeful her application to become a special constable will be successful. She said: 'I can’t wait to get back on the street doing the job I love. It’s been a long time and I know the force will have changed, but I’m looking forward to it. 'It’s not like it was in the ‘80s anymore. The police are actively trying to recruit more transgender and openly gay officers.'

Tuesday, August 28, 2012

Dear Abby

Dear Abby: I am a confused transwoman. I have been in a committed relationship for years with a woman who knew me before “the change.” I have lied to myself for a long time about what gender I have been attracted to, and now it’s coming back to haunt me.
As I have gone through several years changing, my confidence and emotional depth have grown. I successfully transitioned two years ago, and live and work as a woman. This means when I go to clubs and bars with other girlfriends, I attract male attention in a positive way. (I’m attractive and pass well.)
The problem is, my attraction to women is fading and men are now much more appealing. My pulse races at the idea of spending time in the company of men, but no longer with women, who are now more like sisters than anything else.
My relationship with my current female spouse has become that of a housemate or female family member. She was there for me during my changes, and now I feel I am evolving away from her. This upsets me, and I know it upsets her because we have talked about the possibility that this might occur. Now I’m worried about breaking her heart, but feel if I don’t move on, I will have cheated myself out of living.
What should I do? Should I swallow my feelings and stay with her, or admit that in order to feel like a heterosexual woman I must leave and be in a relationship with a man? Help!

Friday, August 24, 2012

16 Days Post-op from FemLar (feminization laryngoplasty) Surgery w/ Dr. Thomas

Christina Goldman: Today I am exactly 16 days post-op from feminization laryngoplasty with Dr. Thomas in Portland Oregon. I have only been able to speak for 2 days now so my voice is a bit hoarse and is lower than the final outcome will reveal. My vocal chords are still enormously swollen and it will take several months for me to achieve my final vocal range. Please feel free to follow my progress on my website . . or on Facebook ( . . . I welcome any and all questions . . even from haters (y'all make me laugh).

Billie Rene: Christina is a remarkable trans woman who has prepared YouTube videos and a blog that show her progress from biological male to female. It is a wonderful resource for those who contemplate the path that she  has followed to develop congruence of her body with how she feels. Modern medical and psychological/sociological research indicates these feelings by trans-people are biologically based and not mere habitual socialization.

In this video  she describes her struggles to overcome her large vocal cavity (larger in males) and thicker vocal cords so she may sound female. This is a struggle for mo
st  given the impact of testosterone on development.  The purpose of this surgery is to revise her genetic inheritance as modified by testosterone.  

We look forward to the inevitable future videos that Christina will provide to document her progress. Best wishes, Christina... You go girl!!!

Sunday, August 5, 2012

Living Transgender In American Society Today

Here is a very good collection of LGBTQ educational Webinars - good for caregivers and others that interface with LGBTQ folks. This list was provided by the Riverside County (Calif) Mental Health LGBTQ Task Force.
LGBTQ Webinars of interest

Transgender Special

Dr. Bruce Hensel talks with transgender individuals in this fascinating special

Transgender Special (part 2) 

Saturday, August 4, 2012

Red Wine Ingredient Slows Growth of Breast Cancer Cells, Study Finds

During your menstrual cycle, estrogen generally triggers the proliferation of cells in the inner lining of your breasts’ milk glands. Providing you don’t get pregnant, these estrogen levels subsequently drop at the end of your cycle, and those milk gland cells deteriorate and die. Because estrogen can’t really tell the difference between normal cells and cancerous cells, though, it will cause cancerous cells to spread just like it would with regular cells. Many drugs used to treat breast cancer, then, are aimed at selectively blocking the effect of estrogen.

In this recent study, researchers treated breast cancer cells with resveratrol and compared their growth to untreated cells. The growth of those cells treated with resveratrol ended up being significantly reduced; tests showed this cell growth reduction was due to resveratrol drastically reducing estrogen receptor levels.

Resveratrol Blocks The Growth Effects Of Estrogen By Reducing The Specific Breast Cancer Receptors

A new research report appearing in the October 2011 issue of The FASEB Journal shows that resveratrol, the "healthy" ingredient in red wine, stops breast cancercells from growing by blocking the growth effects of estrogen. This discovery, made by a team of American and Italian scientists, suggests for the first time that resveratrol is able to counteract the malignant progression since it inhibits the proliferation of hormone resistant breast cancer cells. This has important implications for the treatment of women with breast cancer whose tumors eventually develop resistance to hormonal therapy. 

"Resveratrol is a potential pharmacological tool to be exploited when breast cancer become resistant to the hormonal therapy," said Sebastiano Andò, a researcher involved in the work from the Faculty of Pharmacy at the University of Calabria in Italy.

How to Increase Breast Size With Diet

Breast size is largely determined by genetics. Some women are simply more likely to have larger breasts than others. In addition to genes, there are other factors that can affect breast size, such as hormone levels and overall body weight. As a more invasive and expensive solution, some choose to get bigger breasts via plastic surgery. While you won't experience such dramatic increases in your breast size, you can get bigger breasts via diet. Basic dietary modifications can help you achieve slight increases in breast size.

Monday, July 30, 2012

Do it Yourself Electrolysis

I have been doing my electrolysis myself. It is time consuming and tedious, but a lot cheaper than having someone do it for you. I plan to continue until I finish all the easy-to-reach areas. On the most sensitive spots I apply wintergreen oil to the spot. It has a lot of aspirin so I use it sparingly and only when needed. Read customer comments at Amazon.

Sunday, July 29, 2012

Lynn Conway

Lynn Conway: Computer Scientist, Electrical Engineer, Inventor, Research Manager, Engineering Educator My goal for this website is to illuminate and normalize the issues of gender identity and the processes of gender transition. This project began in the year 2000, as I struggled to "come out" about my past to my research colleagues. I wanted to tell in my own words the story of my gender transition from male to female three decades earlier, in 1968, and then of being outed 31 years later in 1999, while living quietly and successfully in "stealth mode". Since beginning work on this website, I've come into contact with ever growing numbers of people concerned with gender issues. I've interacted via e-mail and in personal meetings with large numbers of people who are transitioning or who have transitioned. Given the still-remaining social invisibility, ignorance and superstitions about gender conditions, I've felt a strong need to provide whatever information, encouragement and hope that I can to help others who are struggling with these issues.
Here is Lynn's personal home page -- EXCELLENT, LOTS OF INFO

Donna Rose

As a leading author, writer, speaker and trainer on transgender and transsexual issues I have been invited to speak and provide trainings at corporations, colleges and universities, and conferences across the country. A full CV of my efforts, a description of my services, and a sample of my training approach is available for download here. These pages will provide some video snippets of various trainings and talks I’ve done around the country over the past several years. Besides being good training materials themselves, they provide a good opportunity to get a sense of my approach, my style, and my abilities. The key to good training on a subject that can be as sensitive and as delicate as this is to engage and educate.

Saturday, July 28, 2012

Lannie Rose - Five years from man to woman

People change
Lannie Rose knows how much a person can change. After all, she used to be a 45-year-old computer engineer—and a male. Then she got the idea that she might actually be a woman, in spite of her male anatomy, and so began her five year journey from man to woman.

Southern Comfort Conference

This year is the 22nd annual Southern Comfort Conference and the theme is “World Tour”. Vendors, authors, entertainers and leaders from the entire spectrum of the transgender community will be in Atlanta to create a 4-day symposium full of learning, networking and fun just for you! From Tuesday through Saturday night, this year’s conference is packed with seminars, on-site activities as well as several planned trips away from the hotel that you are sure to enjoy. There is something for everyone on the SCC. Whatever your connection to the transgender community – whether you are transsexual, a cross dresser or in between; a spouse, a partner or a family member; straight, gay, bi or omni-sexual; post-op, pre-op or non-op; young or old; married or single; FtM or MtF – if transgender is an issue in your life, you are welcome!

Friday, July 27, 2012

My Thoughts

The transitioning process is very difficult and arduous. Personal relations, ID papers, vocational acceptance and psychological "evaluations" needed for surgery. Hormone therapy can be complex. Unfortunately drug trials are time limited and do not consider all the possibly interactions with commonly prescribed drugs.

 I suggest there is a need for people familiar with transgender issues and the processes involved to inform "patients" and be a friend and advocate rather than mere psychological "diagnosing". Transitioning is a very comprehensive task requiring comprehensive knowledge. Some environments "treat" patients on a piecemeal basis--this is NOT a comprehensive approach and resulting confusion is  hardly surprising.

Hair, makeup, shopping, presentation, manners, speech... this is a VERY involved subject that few genetic females really consider, perhaps because they are gradually exposed from childhood. Transitioning of gender role requires a comprehensive knowledge of many subjects.

There is a wealth of information on presentation and "comparative bathroom edicate" for example. Voice and manners is a huge deal. How does one dress, walk, talk, and be courteous?

I've always been a mimic so body language is important to me. Girls learn this and much more though teenage years, but transitioning is a "crash course" for trans-people. Fortunately there are many references and videos available, but this requires diligent study.

 We need a "Charm School for Transgender Women". How does one "Be a girl"? Its all about "Girl Tech" and there is a lot of it. I really like being a "girl" and dress the part. Smile and attitude may get me acceptance wherever I go. People, especially women, react very positively to a smile, being happy and contented with one's self. If someone looks at me, I will smile and look away non-aggressively whereas a guy might look directly in your eyes. I can do this too, but I learned to avoid direct stares and be somewhat more coy.

 Women I don't know say, "Have a wonderful day, sweetie" and they smile to me. WOW, was this a shocker as I never experienced this as a guy. Some come up to me and start conversations. I've had others wave to me across the room. Do they "know"??? I have no idea what so ever, but they like me and I am accepted which I have always wanted from my very earliest years.

Of course, I enjoy being a girl... people like me. At one time I thought they were being "nice" to me trying to make me feel welcome--perhaps. Now, I don't think so... They just like me or perhaps they like my mannerisms, behaviors and comfortableness in my own skin. I like being ME!!!

 Japanese Kabuki actors are male and they study their craft carefully. They are more feminine than women--perhaps effeminate to make a point. So If I am to be really accepted I need to learn "my craft" so I can compensate for obvious physical differences. Now I have acceptance and women like to engage in "girl talk" with me which I love; likely because of mannerisms and courtesy, but not effected effeminate behavior which even women do not utilize.

 I was requested to attend group psych sessions. One day I was slightly exasperated with the others and said, "If you want to be a girl, then be a GIRL" as their presentation and manners were all wrong. They need to WATCH women and see how they act, dress and interact. There is much to learn. Trans folk need coaching. They need to be directed to on-line and published resources. Transgender folk need skills and support, not just psych "evaluation" and monitoring for suicide.

Calpernia Addams :Bad Questions to Ask a Transsexual

Notice how she uses her body language to be more expressive: 
facial expression, smile, gestures, head bobs,etc. These are skills trans women can use to enhance communication and acceptance.


Tuesday, July 24, 2012

Thailand's Got Talent - Man or Woman?

Kids of Trans Resource Guide

A Note from the Author

Allow me to introduce myself. My name is Monica, and my father is a transgender woman who 
transitioned from male to female ten years ago, when I was 17 years old. Until five years ago, I had never met another person with a similar experience. Thanks to COLAGE and the work I've been doing to build our Kids of Trans Program, I now know quite a few people with trans parents and even more transgender people.  

     When my dad first came out to me, she handed me a pamphlet about transgender people. I never
read the pamphlet because I didn't want more information about her; I wanted to know what this all meant for me. Where was the "Your dad just came out as trans… Now what?" booklet that I so desperately needed? I wanted someone to tell me what to expect, how to talk about it, and assure me that there were other people out there with similar experiences. This resource guide encompasses each of these elements as well as other important aspects of having one or more transgender or gender variant parent(s).

Kids of Trans Resource Guide

Saturday, July 14, 2012

GREAT DUET - The Dark Sea

a duet by voice trained trans MtF

A dream come true for เบลล์ นันทิตา Bell Nuntita (Belle) as she finally shares the stage and sings a song with her idol Mum Laconic! 

Special cover performance of "Talay See Dam ทะเลสีดำ (The Dark Sea) [OA: Lula feat. Tar Paradox]" during TV 3 Game Show "Suk12Raasee". รายการ ศึก12ราศี วันที่ 25 มีนาคม 2555


I LOVE THIS -- Bell 
 was runner-up on this show

Amazing Thailand's Got Talent 

"Mom, I need to be a girl" -- book on PDF

Mom, I need to be a girl

You are about to read a rare true story about a young boy who received a kind of help from his mother that some children need, but almost none receive.

Danial should have been born a girl. In these pages, you will meet Daniel's father who believes that sexual reassignment is against God. You'll follow the fencing matches with bureaucrats, and the contest of wills with councilors whose skills are so often limited to dream-obstruction and fee collection. Most importantly, you'll read how Daniel's courageous and superbly understanding mother helped Daniel to become the charming, irrepressible Danielle, despite a globe full of minor tyrants, tunnel vision functionaries, buffoons, financial opportunists, and misguided dogooders trying to prevent it.

Monday, June 4, 2012

Healthy SF to remove trans exclusions

Nearly two years after a complaint was filed charging that Healthy San Francisco, the city's health insurance program for uninsured residents, is discriminatory because it excludes services for transgender people, city officials are in the process of rectifying the situation and including such services in the program.

 Supervisor Scott Wiener and transgender leaders met with the Bay Area Reporter Monday, July 16 and said that city officials are expected to soon sign off on the changes that would allow sexual reassignment services, treatment, and surgery to be covered for transgender patients just as they are now for non-trans patients.

 Barbara Garcia, the director of the Department of Public Health, told the B.A.R. Monday that her agency is committed to the changes, but that it would take another year to year and a half before the administrative steps are implemented, due to contracting requirements. "We're totally committed to it," Garcia said.

 Wiener introduced a resolution at Tuesday's board meeting calling on the health department to "provide medically necessary transition-related care for transgender people and to remove exclusions under the San Francisco Health Care Security Ordinance," or Healthy SF. Healthy SF is the city's locally designed and funded universal health care program that was launched in 2007.

It currently provides hormone treatment and mental health services to transgender participants, but administratively excludes sex reassignment surgery and denies coverage for certain surgical procedures to transgender people when the same procedures are provided to non-transgender participants, "thus denying transgender residents equal access to necessary health care under this local plan," Wiener's resolution states.

Wiener said the costs would be negligible and pointed out that when the city began offering similar benefits to its transgender employees several years ago the actual cost was lower than the projections.