Can You Use Your HSA for Transgender Surgery?

As more individuals seek gender-affirming treatments, the question of whether Health Savings Accounts (HSAs) can be used for transgender surgery arises. In most cases, HSA funds can be utilized for transgender surgery and related medical expenses, as long as they are considered qualified medical expenses by the IRS.

Transgender surgery, also known as gender confirmation surgery, is a vital aspect of gender transition for many individuals. It includes various procedures such as top surgery (breast augmentation or removal), bottom surgery (genital reconstruction), facial feminization or masculinization, and more.

Here are key points to consider when using your HSA for transgender surgery:

  • Transgender surgery must be deemed medically necessary by a licensed healthcare provider to be considered an eligible expense.
  • IRS Publication 502 outlines qualified medical expenses eligible for HSA funds, and transgender surgery is eligible if it is considered medically necessary.
  • Expenses related to hormone therapy, counseling services, and other treatments leading up to gender-affirming surgery are also typically eligible for HSA reimbursement.
  • It is essential to keep detailed records and documentation of all expenses related to transgender surgery to justify the use of HSA funds.

While HSAs can generally be used for transgender surgery, it is advised to consult with a tax advisor or financial expert to ensure compliance with IRS regulations and guidelines.


Understanding whether you can tap into your Health Savings Account (HSA) for transgender surgery is critical, especially as more people pursue gender-affirming transitions. Generally, HSA funds can indeed cover costs associated with transgender surgery, provided these expenses are classified as qualified medical expenses by the IRS.

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