Following news that San Francisco may be the only city in the US to pick up the tab for its employees' sex-change operation, the vote to pass the measure has been postponed.

While nine Board of Supervisor votes are needed, two of the 11 supervisors were absent on Monday when the voting was supposed to take place. One supervisor is known to oppose the measure calling the benefits "reverse discrimination".

Supervisor Tony Hall said, "It's providing treatment to a select group of people, as opposed to all people."

According to the San Francisco Examiner, he also questioned the definition of gender dysphoria, the condition affecting transgender people. "What about people who suffer from appearance dysphoria?"

He added that unlike a heart failure, the sex-change surgery was elective and would cost city workers and retired employees an extra US$1.70 a month for insurance that they might not want to pay.

Supervisor Mark Leno who expects nine votes for the measure when it is taken up again next week, defended the package saying that Hall misunderstood the plight of transsexuals and said that it's not about "special benefits for a group" but "equal benefits".

While only 14 of the 37,000 city employees are self-identified transsexuals, the US$1.75 million cost estimated by the Health Service System would be able to cover up to 35 employees.

Leno said there would be a US$50,000 lifetime cap on the benefits and the insurance would only cover genital reconstruction, hormones and procedures such as hysterectomies and mastectomies and not elective surgery or cosmetic procedures.

An average male-to-female surgery costs about US$37,000, while female-to-male surgery about US$77,000. The overall health package would also extend to infertility treatment, hearing aids and acupuncture.

Minnesota offered similar benefits, but its program was phased out in 1998.