In a move that will make San Francisco the first city in the U.S. to provide and cover the cost of sex reassignment surgeries, the city's Health Commission voted Tuesday to remove mastectomies, genital reconstruction and other surgeries recommended for transgender people from the list of procedures specifically excluded from the city's Healthy San Francisco universal health care plan.

Healthy S.F., implemented five years ago by Mayor Gavin Newsom, currently covers treatments such as hormone therapy, counseling and routine health services for the city's transgendered residents, but does not cover surgical procedures recommended for patients whose physical appearance is at odds with their gender identities. Following recommendations from the San Francisco Board of Supervisors and the locally based Transgender Law Center, the commission agreed to create a new program that will cover all the parts of transgender health. The city of San Francisco currently covers the cost of reassignment surgeries for government employees, but the local community felt their exclusion from HealthySF was a discriminatory.

At the moment, the vote is mostly a symbolic gesture. According to the AP, the city doesn't currently have the necessary expertise or capacity to provide such procedures through city clinics or the public hospital. As Public Health Director Barbara Garcia explained, the program should be running by the end of next year once her department determines how much the program will cost and who will perform the surgeries.

"Sex reassignment surgery is not the end all. It's one service that some transgender people want and some don't," Garcia explained. "We can probably manage this over the next three years without much of a budget increase because we already have these (other) services covered."

[AP/Mercury News]