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A vote that would have made San Francisco the only city in the nation to pay for employees’ sex changes was postponed Monday after one supervisor disapproved of adding such health coverage. 

The measure needed nine Board of Supervisor votes, which was impossible with two of the 11 supervisors absent and Supervisor Tony Hall speaking against it. The issue will be taken up again next week when a full nine votes of approval can be obtained, said Supervisor Mark Leno, who has worked two years to have the benefits added. 

Calling it “a case of reverse discrimination,” Hall said he could not support the issue because his office has been inundated with opposition. He views the sex-change surgery as elective and said it would cost city workers and retired employees an extra $1.70 a month they may not want to pay. 

“This is not like heart failure,” Hall said. “This is an elective procedure.” 

The issue had not received any public opposition until Monday, but a handful of people said they did not support the benefits. 

“Why should insurance companies pay for something like this?” asked Jane Cogswell, 81, a retired nurse and long-time San Francisco resident. “Then you get paid when you’re lying in the hospital with a new penis and a new uterus.” 

Leno argued the insurance would not cover elective surgery or cosmetic procedures. It instead would pay for genital reconstruction, hormones and other medical matters such as hysterectomies and mastectomies only after a doctor deems it medically necessary. 

He stressed there would be a $50,000 lifetime cap on the benefits, which would begin July 1. 

An average male-to-female surgery costs about $37,000, while female-to-male surgery runs about $77,000, a cost Hall said is too much to force on city employees without polling them first. 

Board President Tom Ammiano and Supervisor Gavin Newsom were absent for Monday’s vote. Leno said both support the issue and will vote in favor of it next week. 

The city currently has about 14 transgender employees out of its 37,000 workers. The insurance changes that would cost $1.70 a month would include items such as hearing aids and acupuncture, in addition to the sex-change benefits. 

San Francisco apparently would be the only governmental body in the nation to make sex-change benefits available. The state of Minnesota offered such benefits, but the program was phased out in 1998. The issue was discussed in Oregon, but a commission decided against it in 1999. 

The term transgender covers a broad range of categories including cross-dressers, transvestites, transsexuals and those born with characteristics of both sexes. 

On the Web: 

San Francisco Human Rights Commission: http://www.ci.sf.ca.us/sfhumanrights/