According to this article:
http://health.usnews.com/health-news/news/articles/2012/02/20/gender-ide...
You can see that transgenderism and gender identity issues are closely linked to poor mental health issues. As to top it all off, you can tell from this article:
http://www.law.com/jsp/article.jsp?id=1202432579448&Federal_Judge_Says_S...
It is incredibly misleading, having some costs covered [such as hormones], but the procedure not, and it's detrimental that the surgery itself be covered, as many individuals require it to feel comfortable, happy.