It shouldn't matter whether breast enhancement for GID patients is a "core" medical necessity. What ought to matter is that a human being is suffering and the medical establishment has the technology and resources to help.
When everybody else -- surgeon included -- are swept up in a decision to do a procedure that's not in the best interest of the patient, the anesthesiologist represents one last chance for somebody to say, "not on my watch."
Even though I knew I would encounter many mixed reactions to my decision to get breast implants, I'm frustrated by people who are so rattled by my choice. It was my journey. I did it for me; no one else.