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.