The memo referred to a man who suffered from Gender Identity Disorder (GID) since childhood and, upon the diagnosis and recommendation of his therapist and a doctor, entered into hormone therapy, lived as a woman, and eventually had gender reassignment surgery to become a female.
The IRS said that IRC Section 213 does not include cosmetic surgery under the term medical care unless the procedure is necessary to correct a deformity directly related to a congenital abnormality, an injury resulting from an accident or trauma, or a disfiguring disease. According to the IRS, the code defines cosmetic surgery as a procedure that is directed at improving a person’s appearance and does not promote the proper function of the body, or treat illness or disease, as the term medical care requires.
The IRS concluded that, “Without an unequivocal expression of Congressional intent that expenses of this type qualify under section 213, allowing the medical expense deduction is not justified in this case.”
The IRS memo from the Office of the Chief Counsel is here .