On November 8 the Associated Press reported “San Francisco has approved a measure that utilizes taxpayer funds to pay for the sex-change operations of the uninsured, becoming the first city in the nation to do so.” The article reported that the city’s Department of Public Health was urged to adopt the new policy by the San Francisco’s board of supervisors and the SF-based Transgender Law Center. The plan will be part of the Healthy San Francisco program which provides medical care for the uninsured. Healthy San Francisco receives funding from employers, the city, and the federal government.

The city’s director of public health is open lesbian Barbara Garcia. Garcia described the new policy as “a symbolic process for now because the city currently does not have the expertise, capacity or protocols in place to provide the surgeries through its clinics and public hospital. The community felt the exclusion on Healthy San Francisco was discriminatory and we wanted to change that as the first step,” she said.

Instead of expanding the existing plan, the health commission approved the establishment of a separate program that covers all aspects of transgender health, including gender transition. Garcia hopes to have it running by late next year, but said her department first needs to study “how many people it would serve, how much it would cost, who would perform the surgeries, and where they would be performed.”

In a November 11 article on the same story, Christian News was able to indicate how much such surgeries would cost the taxpayers. They wrote, “According to reports, male-to-female surgeries cost approximately $37,000 and female-to-male surgeries cost $77,000.”

Christian News also noted that one San Francisco resident, Thomas Moyer, said that the policy “…was approved despite Mayor Ed Lee’s slashing of other city services and increased taxes due to record budget needs of $7 billion dollars….’Taxpayers cannot afford this, as there are unintended costs and unintended consequences unrelated to the actual surgery, such as their longer-term hormone treatment, psychology needs, and other longer-term health issues.”  While that would seem to be a sensible objection, it ignores Mayor Lee’s longtime ties to the transgender community.  Within six months of his selection as the replacement for outgoing Mayor Gavin Newsom, Lee became the first mayor in the city’s history to address the city’s transgender march. Before his selection, Lee had promised not to run for mayor after his term was finished, but when he attended the march, San Francisco political insiders saw it as Lee’s first step in reneging on his pledge, which proved to be the case.

Less than a week after the new policy was announced, the U.S. Census Bureau released statistics showing that California has the highest poverty rate in the nation. The statistics, which are based on a new model developed by the bureau, have California leading the nation with a poverty rate of 23.5 percent. It is followed by the District of Columbia—the only two locations in the country with a poverty rate over 20 percent.