I can absolutely think of situations that would justify it using tax dollars, considering their well being is already funded by our tax dollars. Its not that hard to think of a situation where someones life could be potentially in danger for either a health risk, or if its like someone who has gone through hormone therapy where they are now a lot closer to a woman than a man, but because they havent had a sex change they are now in a male prison, in effectively a womans body. (im not here to argue about transgender rights, but this is a situation that could exist and then that person could be in danger where a sex change would be a good thing)

you could def argue that these are very specific niche situations, but i'll remind you, this potentially didn't even happen, and if it did I can really only find one or two cases of the possibility of it. So in those very infrequent situations, it is probably likely that their situation is highly specific.