Insurers may not be saving themselves a lot of money when they deny claims for transgender surgery and other care related to gender identity.  

A survey of 355 transgender-identified people conducted by TrueChild, a transgender rights advocacy group, found that there are many costs associated with denying people the care they have requested.  

For starters, those who are denied gender-related surgery often seek out alternative medical services to cope with the disappointment and depression from the rejection. Thirty-five percent of respondents reported seeking psychotherapy as a result of having a gender-related care request denied.  

Many of those who don't seek out psychiatric professionals cope in more destructive ways. The survey found that 37 percent reported turning to drugs and/or alcohol after a rejection and 36 percent reported other physical symptoms as a result of depression. A shocking 15 percent of respondents reported attempting suicide. 

Not only might it cost private insurers more money to deny gender-related care, but the study suggests it causes a strain on public finances. The poll found that 23 percent of respondents became unemployed after having a claim denied and 14 percent became homeless.   

"Insurers and policy-makers have had an antiquated list of exclusions written that have not evolved over several decades," said John Hodson, president of True-Benefit, which commissioned the report from TrueChild. "Indeed, the thought was that denying care for transgender medical care saved money for policy holders. This report shows that's not true." 

The survey is being released in the midst of proposed rules by the Obama administration to bar health care providers from denying certain gender-related care.