Private ruling: Medical expenses tax offset for gender reassignment surgery
Date of advice: 27 June 2022
Published: November 2022
Ruling period: Year ended 30 June 20XX
Date scheme commenced: 1 July 20XX

Ruling: Q1: Are you entitled to a medical expenses tax offset for expenses paid in undergoing gender reassignment surgery? | A1: Yes. Having considered your circumstances and relevant factors you are entitled to include the expenses you incurred for the gender reassignment surgery when claiming the medical expenses tax offset, as the payment you incurred is not an ineligible medical expense as defined in Sub-section 159P(4) of the Income Tax Assessment Act 1936 .

Relevant facts and circumstances: You are an Australian resident for taxation purposes. You were diagnosed with the condition of Gender Identity Disorder and you required appropriate surgical treatment, this being a Sex Reassignment Surgery. The only facility available at the time an Australian institution, however, due to your age and other relevant conditions that applied, you were not eligible to have the surgery at this facility. Due to this you were referred to another institution that was overseas, in Country A. You had the operation and you now wish to claim the expense in the medical expenses tax offset in your 20XX-XX financial year income tax return. You have supplied a Statutory Declaration declared and signed by you on early 20XX, which outlines a timeline relating to your medical diagnosis and eventual surgery: • In mid- 20XX, your Medical Practitioner in Australia referred you to a consultant Psychiatrist (your Psychiatrist) for assessment for suspected Gender Identity Dysphoria (GID). • Your Psychiatrist diagnosed you as manifesting GID and supported the appropriate treatment by your Medical Practitioner's Clinic. • Recommended treatments for GID include Sex Reassignment Surgery (SRS). • In face- to- face consultations in mid-20XX and late- 20XX and again in early 20XX, your Psychiatrist and yourself discussed the appropriateness of SRS in your case. They advised you that the only facility in Australia to which your Psychiatrist might refer you for SRS was a particular Australian institution. However, your Psychiatrist explained that Australian institution only accepted patients for SRS who had been under their direct psychiatric assessment for a period of two years, and that they had an upper age limit of 65 for patients undergoing SRS. • You were close to this age limit at the time and had never consulted the psychiatric practitioners at that Australian institution,and would therefore be ineligible for surgery there. • Your Psychiatrist then referred you to an overseas medical surgeon, a highly regarded surgeon in the field, in Country A, for SRS. • In mid- 2011, you undertook SRS with the overseas medical surgeon. You have supplied a medical certificate dated in mid- 20XX and signed by the overseas medical surgeon which confirms: • Following a period of diagnosis by qualified psychosexual specialist and a continuous appropriate period of living full-time in your acquired gender, you were diagnosed as suffering from Gender Identity Disorder, and you were then referred for the appropriate treatment (SRS). • You underwent SRS performed by the overseas medical surgeon under the auspices of the relevant overseas institution in Country A in mid- 20XX. • In accordance with all presently known and accepted medical and legal definitions, the operation has irreversibly and permanently changed you from your previous gender to your new gender. You incurred the full cost of the expenses for the surgery, as confirmed by the supplied payment receipt issued from the overseas institution dated mid-20XX.

Relevant legislative provisions: Income Tax Assessment Act 1936 Section 159P