46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or both ovarian and testicular tissue, or (bb) other physician-diagnosed disorder of sexual development, with respect to which the physician has determined through genetic or biochemical testing that the individual does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a biological male or biological female, or (II) treatment of any infection, injury, disease, or disorder caused or exacerbated by the performance of any gender transition procedure, whether or not the gender transition procedure was performed in accordance with State and Federal law or whether not a deduction for expenses in connection with the gender transition procedure is allowable under this chapter. (iii) Gender The term gender means the psychological, behavioral, social, and cultural aspects of being male or female. (iv) Gender transition The term gender transition means the process in which an individual goes from identifying with and living as a gender that corresponds to his or her biological sex to identifying with and living as a gender different from his or her biological sex, and may involve social, legal, or physical changes. (v) Gender transition surgery (I) In general The term gender transition surgery means any surgical service, including genital or non-genital surgery, performed for the purpose of assisting an individual with a gender transition. (II) Exception Such term does not include any service performed because the individual suffers from a physical disorder, physical injury, or physical illness which would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed. (vi) Genital surgery The term genital surgery includes surgical procedures such as— (I) penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male patients, and (II) hysterectomy, ovariectomy, reconstruction of