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I'm not sure how many US insurance companies cover sex reassignment surgery, but I don't think it's very many. I have read a few forums for MTF and a common theme is that the biological "males" would feel more comfortable with a body to match their mind. However, this presents a class difference: those who can afford the surgery and those who can't. Another issue is that being transgendered is a psychiatric disorder in the DSM-IV (it's still being debated for the DSM-V.) I think putting the label of "mental disorder" on it makes being trans even more stigmatized. That means being trans is abnormal and should be treated. I think it's just a matter of a person's feelings not agreeing with societal rules for a sex identity to correspond with a gender identity.