The city of San Francisco is expected to approve unprecedented legislation granting health care benefits to city workers undergoing sex-change procedures, the San Francisco Chronicle reports. If approved by the board of supervisors and Mayor Willie Brown, the new plan would cover sex-change operations, hormone treatments, and related needs. Earlier this month the citys Health Service System approved the plan, which would significantly lower costs for city employees changing from male to female or female to male. This is very much a civil rights issue, said supervisor Mark Leno. This is about equal benefits for equal work. Officials estimate that about a dozen self-identified transgendered people are on the citys payroll. Some have opted for surgery, but others have limited their sex-change treatment to hormones because of the high costs of surgery. For males changing to females, surgery costs about $37,000. For females becoming males, costs can run as high as $77,000. The proposed benefits cap at $50,000 per person for life, but the patient is required to pay 15% of the expense if a doctor affiliated with the citys health plan performs the operation. Copayment jumps to 50% for a physician not on the health plan. Some activists are concerned about the required copayment, considering that in most cases the full cost of all other surgeries is covered for city employees. Also, a city worker may have to be on the payroll for at least a year before the proposed benefits kick in, whereas benefits for other employees start immediately. Even though were not happy with the limitations, we think the fact that the benefits are being offered is wonderful, said Larry Brinkin, senior contract compliance officer for the San Francisco Human Rights Commission, which advocated for the new benefits. The benefits might cost the city $1.75 million the first year if 35 people take advantage of the full $50,000 benefits, though officials say that the figure has been overestimated. Legislators and activists say no other city, county, or state in the United States offers similar benefits to employees.