Not to get too far off topic, I can agree with you to a point, but in many cases transition and SRS is a life saving procedure. While FFS could be considered cosmetic, transition has been shown to be an effective treatment for gender dysphoria and is no longer considered experimental by Medicare. In recognition of that, several states have mandated inclusion of coverage and and/or offer it to state employees. I know the federal government can't mandate to the states but is going to be up to the legislatures or Insurance Commissioners. For some, SRS IS emergency, lifesaving treatment and therefore worthy of coverage.