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JACKSONVILLE, Fla. -- A 33-year ban on Medicare coverage for sex-change operations has been lifted.

This move could cause a domino effect when it comes to private insurance plans.

The changes could affect Kai Puhl. Puhl's short cut and the facial hair -- reflects how he feels inside, but he was born a girl.

Related: Medicare ban on sex reassignment surgery lifted

"I didn't allow myself to acknowledge on a conscious level what I have been experiences since I was five until I was 34," Puhl said.

For decades Puhl suffered from gender dysphoria-- a condition many men and women battle every day.

Medical professionals now say a safe option for people uncomfortable in their own skin, like Puhl-- is sex-change surgery.

"It validates what we experience as trans people. And lets the world know this is not just in our heads. This is not something we make up. It's a legitimate medical necessity," Puhl said.

A ruling by a Department of Health and Human Services board ended a national policy of not covering surgeries that Puhl says could save lives.

Sex-change surgery can be covered by Medicare.

Puhl is hopeful private insurance companies will soon follow suit.

He's now in transition-- and plans to undergo some very expensive changes.. That could total up to $58,000.

"I want to have the whole surgery. I want the top surgery I want the bottom surgery. I want to die being recognized as a man completely," Puhl said.

Local family law attorney, Carrington Mead tells first Coast News she's had clients that have completely depleted their savings and retirement accounts -- because their insurance companies would not cover their sex-change.

She says this federal move will likely lead to other insurance plans adding gender reassignment as a covered option.

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