Gender Identity Disphoria is a mental condition listed under the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), wherein a person has the desire to live as an individual of the opposite gender. An estimated 2 to 5% of the population is transgender (i.e., experience some degree of gender dysphoria). For many transgender individuals, this is crippling.

41 percent of transgender people in the United States have attempted to commit suicide, according to a 2010 poll. About 19 percent of transgender people report being refused medical care because of their gender-nonconforming status, and a shocking 2 percent have been violently assaulted in a doctor's office. 55% of transgender youth report being physically attacked. 74% of transgender youth reported being sexually harassed at school, and 90% of transgender youth reported feeling unsafe at school because of their gender expression.

These statistics are just some of the sobering findings from a survey of more than 7,000 transgender people conducted by the National Center for Transgender Equality and the National Gay and Lesbian Task Force, released in October 2010, as well as the annual National School Climate Survey.

Gender Reassignment surgery is an expensive procedure, only available from a few doctors nationwide, and it is currently regarded by insurance companies as an elective, cosmetic medical procedure, and is therefore not covered. This leaves many transgender individuals in a dangerous middle area, where they have begun to transition but cannot complete it. With rising medical costs, and poverty afflicting a large volume of transgender individuals, it is left out of reach of many.

As gender identity is not listed as a protected class under most states or the bill of rights, this makes them a target for violence, discrimination, and poverty. In those states that do allow changes on birth certificates, driver's licenses, and other documentation, a requirement is often that the individual be post op. This puts most transgender people into a legal grey area that leaves them vulnerable to discrimination. One in five transgender people in the U.S. have been refused a home or apartment, and more than one in ten have been evicted, because of their gender identity. More than one in four transgender adults have lost at least one job due to bias, and more than three-fourths have experienced some form of workplace discrimination. Biased refusal to hire, privacy violations, harassment, and even physical and sexual violence on the job are common occurrences, and experienced at even higher rates by transgender people of color. Many report changing jobs to avoid discrimination or the risk of discrimination.

This all culminates in one damaging, entrapping status for transgender individuals: unable to move forward with their transition, stuck in a dangerous middle zone of harassment and discrimination, including within the government.

Forcing insurance companies to cover sexual reassignment surgery under the Affordable care act would alleviate much of this, it won't solve everything, but it will make things much better for many, many transgender individuals. Able to afford the surgery, many transgender people would be able to achieve a greater degree of happiness and satisfaction with themselves, be less likely to use drugs, less likely to commit suicide, and less likely to be the target of violence. It would allow transgender people to move forward with their transitions confidently, and complete the paperwork many states require in order to legally recognize them as their chosen gender. Freeing these people of this burden of dysphoria would allow them to become healthy and productive members of society.