PULLMAN, Wash. — A hospital in Pullman will be the first in Washington to offer sex reassignment surgery, after its Board of Commissioners agreed to expand service for people with gender dysphoria.

The board of Pullman Regional Hospital voted unanimously Wednesday to provide the surgery.

The Spokesman-Review says the hospital expects to perform no more than two operations per month, and anticipates this will result in an annual net loss of about $49,000.

Scott Adams, the hospital’s chief executive, says he views the surgery as just another form of care for a demographic they have been helping for years with other procedures.

The surgery proved polarizing when the hospital asked for public comment in June on whether they should offer it. The hospital received 260 replies in support and 80 against the surgery.

Information from: The Spokesman-Review, http://www.spokesman.com