Coincidentally, on the day my transgender-themed Modern Love column was published in the New York Times’ Style section, the Times’ New York/Region section ran a heartbreaking story by writer Laura Rena Murray about transwomen getting back-alley silicon injections by so-called “pumpers” to look more feminine. Here’s the “nutgraf,” as we say in the news biz:
“Pumpers and their desperate transgender clients operate in an underground world rarely glimpsed by most New Yorkers. But the practice is commonplace, especially among immigrant and poor women, according to dozens of transgender women, social-service providers and doctors interviewed in recent months. Although there are no reliable statistics on the number of transgender people in the city, a recent study prepared by the health department estimated it at 12,500. And according to the same study, 22 percent of transgender women have had silicone injections.”
The backdrop of my column was about my spouse’s “facial feminization surgery,” a procedure performed by a plastic surgeon in a hospital. It’s usually paid for out of pocket, which means only patients with access to several thousand dollars can afford the surgery. (Our story is updated in my Boston Globe article from Aug. 9.)
Of course what all this is about is the HUGE stigma surrounding men looking/being feminine in any way. While women looking masculine have their own set of issues, the societal pressures are nowhere near as close, IMO. Really stop and think how YOU feel about this and WHY. I think about it a lot, as I, too, fall victim to the double standard.
She Was the Man of My Dreams 
A federal tax court ruling last year opened the door to facial feminization surgery being a tax deductible medical expense, provided the taxpayer can document (ie a signed, detailed letter from the doctor) that it was necessary for the gender transition and not purely for beautification.
Click to access odonnabhain-win.pdf
That is correct, and it’s a wondrous thing. However, if one can’t afford the surgery, then the deduction will probably not be the deciding factor. What will change the situation is if insurance plans allow it. That is slowly starting to happen. It’s all about more people demanding it and more big employers feeling they need it to show they are fair-minded companies. Much like domestic partners being covered. The Transgender Legal Defense and Education Fund and Human Rights Campaign are working on it.