Rhiannon O’Donnabhain “lived in anguish” as a male, struggling with the sense that she was, in fact, a female.

In 1996, she was diagnosed with gender identity disorder and undertook a course of professionally prescribed medical treatments that included her 2001 sex reassignment surgery.

Ms O’Donnabhain claimed the cost of her treatment as a deductible medical expense on her federal income tax return, but the Internal Revenue Service denied the claim, calling the surgery “cosmetic,” like teeth whitening or hair transplants.

Ms O’Donnabhain is challenging that denial.

The trial in O’Donnabhain v. Commissioner of Internal Revenue begins today in Boston.

Gay Lesbian Advocates Defenders (GLAD) will argue in U.S. Tax Court that Ms O’Donnabhain’s sex-reassignment surgery was clearly medical care, and therefore as deductible as an appendectomy or heart bypass surgery.

According to Ms O’Donnabhain’s health care providers, the treatment was critical to her mental health and ability to function at all levels.

“Rhiannon O’Donnabhain deserves to be treated equally with every other hard-working American taxpayer.

“The IRS has politicised what should have been a routine medical deduction,” GLAD staff attorney Karen L. Loewy said in a release.

“With every mainstream medical authority from the American Psychiatric Association to the National Institutes of Health recognising gender identity disorder and its treatment, it’s ludicrous to call this surgery cosmetic.”

Ms O’Donnabhain paid approximately $25,000 (£12,500) out-of-pocket for her care, including therapy, hormone treatment and surgery.

The amount of the deduction she is seeking from the IRS is about $5,000.

“While the money is significant to me, this is really about the underlying principle,” said Ms O’Donnabhain.

“I hope this case sends a clear message that transgender people deserve dignity, respect and equal treatment for our medical care.”

Ms Loewy and GLAD senior staff attorneys Bennett Klein and Jennifer Levi will represent Ms O’Donnabhain.

GLAD is working with lawyers from the Boston law firm of Sullivan Worcester, who are serving as cooperating tax counsel in the case.

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