Monday, January 23, 2006
The IRS has ruled in Chief Counsel Advice 200603025 that male-to-female gender reassignment surgery does not qualify as a deductible medical expense under § 213:
On the taxpayer’s Year 6 return, the taxpayer reported medical and dental expenses for an amount exceeding $___.... The expenses included payments for various doctors, prescriptions, health insurance, transportation and lodging in connection with the taxpayer’s gender reassignment surgery (GRS). In a report dated July 2, Year 8, the Revenue Agent disallowed the expenses on the ground that they were for cosmetic surgery and nondeductible pursuant to § 213(d)(9).
§ 213(d)(9)(A) provides that the term “medical care” does not include cosmetic surgery or other similar procedures, unless the surgery or procedure is necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. § 213 (d)(9)(B) defines “cosmetic surgery” as any procedure that is directed at improving the patient’s appearance and does not meaningfully promote the proper function of the body or treat illness or disease....
Whether gender reassignment surgery is a treatment for an illness or disease is controversial....To our knowledge, there is no case law, regulation, or revenue ruling that specifically addresses medical expense deductions for GRS or similar procedures. In light of the Congressional emphasis on denying a deduction for procedures relating to appearance in all but a few circumstances and the controversy surrounding whether GRS is a treatment for an illness or disease, the materials submitted do not support a deduction. Only an unequivocal expression of Congressional intent that expenses of this type qualify under section 213 would justify the allowance of the deduction in this case. Otherwise, it would seem we would be moving beyond the generally accepted boundaries that define this type of deduction.