I'm wondering this as I prepare for tax season.

I know that FFS is iffy because the IRS treats it like cosmetic surgery but SRS is deemed medically necessary. Given that I have a diagnosis for androphonia and vocal tremor I wonder if I can deduct VFS.

Anyone done this? Talked to an accountant about it?

I can also deduct travel and lodging expenses apparently.

I can apparently also deduct the cost of therapy which has been running $240 a month for me.

Hmm.

I can't deduct the cost of VFS because mine was paid out of a medical savings account but i think yours should be. I was able to deduct Electrolysis, Therapy and any medical cost that weren't covered by insurance. You may need a note from your doctor indicating it was medically necessary but if you have an accountant preparing your taxes, they should be able to learn the details.

By the way, the first year I did that, my medical cost were so high I was audited so make sure you follow the law to the letter and keep all records. I did and and I passed the audit without problems.

Well I just found out it has to be at least 10% of your AGI so in my case I can't deduct anything... bummer.

But I did set up my medical FSA for next year so I should be covered. Bad news is it's only $2500. I could only get a HSA if I opted in the company high deductible plan which has high deductibles and co pays. Given that I go to the doctor every 2-3 months that's not doable.

Medical expenses in excess of 10% of your AGI are deductible. I know I have more than enough expenses to meet that threshold this year. You can deduct milage to and from doctors appointments as well as prescriptions and the actual doctors bills. I believe that FFS is also deductable as medically necessary for transition.

I guess it's possible to deduct FFS if you can get proof that it is related to gender dysphoria.

Quote from: iKate on December 03, 2015, 10:03:58 AM
I guess it's possible to deduct FFS if you can get proof that it is related to gender dysphoria.

This in no way is to be considered legal or tax advice, please consult your own attorney or accounting professional, with that disclaimer in place I would like to offer my .02 cents. 

In February of 2010, the Federal Tax Court ruled in favor of a transsexual woman in the landmark case of O'Donnabhain v. Commissioner of Internal Revenue. The favorable ruling opens the doors wide to tax equality for transgender Americans.

Citing protocol from Harry Benjamin/WPATH Standards of Care and DSM-IV, the court ruled that medical treatment for gender identity disorder (GID) qualifies as tax deductible medical care under the Internal Revenue Code.

There are some issues as to breast augmentation and whether it is cosmetic or medical.  I don't believe that the issue was fully litigated and there have been changes in the WPATH standards since then.  Additionally, with more insurance companies agreeing that FFS and Breast Augmentation are medically necessary I believe that there is a strong argument that all procedure's - FFS, GRS, VFS and Breast Augmentation - are deductible.

Your mileage may vary.

***DISCLAIMER: I am an attorney licensed in the States of California and Arizona. However, nothing said below can be construed as either legal advice or creates any attorney-client relationship. Readers are encouraged to seek competent counsel for their own particular needs. IRS  ***


I agree that this issue probably is due to be revisited.  I think the main pushback will be regarding the breast augmentation surgery. It would require a finding of fact in each particular case that BA is not just for cosmetic purposes as defined in 26 USC §219(d)(9)(b). The concurrence seemed to reject the decision that BA could ONLY be cosmetic.

A quick google-fu shows that HSA/HRA/FSA use the same standards. so I don't know if an HSA would even be a solution for you.

I would suggest that you carefully get written documentation from your health providers that any treatement is, in their opinion, medically necessary to treat GID.

I wouldn't place BA in the same category as the other surgeries because plenty of cisgender women have flat chests even after their ovaries generate hormones in the right amounts and right cycle, therefore a trans woman's chest on hormones theoretically reaches its natural potential too, maybe slightly less. But it doesn't really affect passing as much unless the chest is totally flat (and bear in mind, some cis women have totally flat chests too.) If it was covered for cis women for image issues and not only reconstruction from cancer that would be a different story though.

So, I was fortunate enough to have my mother help fund my VFS surgery. I could try to deduct it on my taxes, but could she do the same for hers? I am not sure if this is only applicable to the person who had the surgery. I am not a dependent, if that matters. Not expecting to get anything back, but it can't hurt to try. Thanks. : )

Quote from: iKate on December 04, 2015, 12:43:09 PM
I wouldn't place BA in the same category as the other surgeries because plenty of cisgender women have flat chests even after their ovaries generate hormones in the right amounts and right cycle, therefore a trans woman's chest on hormones theoretically reaches its natural potential too, maybe slightly less. But it doesn't really affect passing as much unless the chest is totally flat (and bear in mind, some cis women have totally flat chests too.) If it was covered for cis women for image issues and not only reconstruction from cancer that would be a different story though.

I kind of agree with you, but I feel like one could just as easily argue that "masculine traits" such as brow bossing are also present in many cis women too. It's all just "natural potential", right? Where ever the line gets drawn, it's kind of arbitrary.

Quote from: Andromeda on December 10, 2015, 11:15:27 AM
I kind of agree with you, but I feel like one could just as easily argue that "masculine traits" such as brow bossing are also present in many cis women too. It's all just "natural potential", right? Where ever the line gets drawn, it's kind of arbitrary.

Can't say I fully disagree with that either.