Medicaid officials are planning to revise regulations in order to make clear that the state will not fund sex-change operations. However, the state will most likely have to pay for such operations before the new regulation goes into effect.

Last month, the state appeals board ordered Medicaid to pay for two people to travel out of state to Washington to undergo sex reassignment surgery. The state estimates the costs at around $50,000 each.

State Medicaid director Doug Porter said that the issue is highly controversial and it must be made clear that the government will not fund such operations. However, it will continue to cover other medical services such as hormone treatment and psychotherapy for people diagnosed with a gender identity disorder.

The state argues that these treatments are as effective as an operation, but are much less dangerous and much less costly. However, many transgender individuals and medical experts maintain that the surgery is, in some cases, the only effective treatment for gender identity disorders.

Lee, one of the two people who won an appeal for gender reassignment surgery last month, said that the operation is “the only thing that repairs our mental health and makes us feel whole.” Lee, 51, has received hormone treatment and has lived as a woman for the last six years. She is supposed to undergo the surgery this fall.

Chris Daley, the director for the Transgender Law Center, said the states plan to take sex-change operations off the list was politically based and is negative publicity, saying that people who undergo the surgery are often able to become productive members of society for the first time. He added that depriving people of necessary healthcare was not cost effective.

Gender identity disorder has been recognized for over 20 years by the American Psychiatric Association, though few government or private insurance programs cover it. Washington is one of the few states where the surgeries have been covered by Medicaid.

Medicaid officials say that the state has only funded six operations in the state over the last 15 years and while those operations only comprised a small portion of surgeries covered by Medicaid, the issue caused political upheaval earlier in the year.

When the states auditor’s office revealed that the state had funded sex-change operations, the Republican members of the state legislature attempted to institute a ban, which proved unsuccessful. Even before the political outcry, Medicaid officials were working on regulations which classify the surgery as “experimental” and not suitable for coverage. Officials say that state has funded two such surgeries since 2000 at a total cost of around $113,000.