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Once a trans person has accepted their gender identity and decided to begin transitioning, it’s an exciting and liberating time. Everyone’s transition looks different, and each person may choose varying interventions. But as soon as someone starts looking at the costs, which could include doctor appointments, bloodwork, hormones, legal name and gender marker changes, a whole new wardrobe and potentially, surgeries, the costs can skyrocket quickly.
This is an especially tough pill to swallow for the trans community, which already faces significant financial disadvantages compared to the general population, according to the National Center for Transgender Equality. As revealed in their 2015 report, this is because many trans people face unsupportive families and suffer from discrimination with employment and housing, which results in financial distress and homelessness at higher rates than cisgender people.
“In the trans community, we see the highest amount of unemployment and housing insecurity,” said Emmett Schelling, executive director of Transgender Education Network of Texas. “Most trans people can’t save money because they’re worried about their day-to-day survival.” This makes it difficult to find money for binders, electrolysis or other transition-related needs when just getting by can be a struggle.
While there are some transition-related expenses that are difficult to avoid, many can be reduced or wiped out with the help of certain resources and strategies. Here’s how to save on several of the most common expenses.
How much does it cost to medically transition?
Not every trans person desires hormone therapy or surgeries. But for those who do, the costs can be high and vary greatly depending on the provider and whether you have health insurance that covers it.
For some ballpark figures, below are the costs of some of the most common transition-related surgeries at The Philadelphia Center for Transgender Surgery, including hospital and anesthesia costs. Note that this clinic and others provide a discount when multiple surgeries are done at once.
For trans women seeking hair removal, electrolysis and laser hair removal are used because they’re the most permanent methods. However, costs may vary drastically, since the number of sessions required to achieve results is unique to each individual and the amount providers charge can differ significantly.
Male-to-female confirmation surgeries and procedures
Thyroid cartilage reduction (trachea shave)
Female-to-male confirmation surgeries and procedures
Basic chest masculinization
How to finance your transition
Apply for grants
If you want a surgery or procedure that’s still beyond what you can afford, consider applying for a grant. There are several specifically for people who need assistance while transitioning.
“There are a few different nonprofit organizations out there that provide financial assistance for people seeking gender affirming surgery or electrolysis or binders,” said Ryan Sallans, a transgender author, public speaker and diversity trainer. He is also a volunteer vice president of The Jim Collins Foundation, which has an annual grant cycle that awards financial grants for gender-affirming surgery to a limited number of applicants. They offer one type of grant that pays for 100% of surgical fees.
“It makes us a unique organization,” Sallans added. “Being able to tell people that 100% of surgical fees are covered is completely life changing, because a lot of people aren’t able to even put down $1,000 or $2,000 for a surgery.”
Through a legacy donation by a trans woman, they also have a grant available that provides 50% of funding and requires the individual to put down the other 50%. “I actually really love that grant — sadly it’ll be gone in two years — because there are many people who may have most of the money,” he said. “They just don’t have that last piece.”
According to Sallans said each year, they typically receive 400 to 500 applications, and in the past, they were only able to award one to three grants annually. For the last two years in a row, they’ve been able to provide three grants that covered surgeries at 100% and two that covered 50%. The amount they can give out each year depends on how much they’re able to fundraise.
The nonprofit Point of Pride also started offering surgical grants for the trans community a few years ago, and they’ve given out more than $103,000 total in grants. They also have a program to help with the costs of electrolysis for permanent hair removal.
Get creative with fundraising
If you’re struggling to piece together enough money for transition-related expenses, you may turn to credit cards or a loan. But rather than getting into debt, consider fundraising first. Many trans people turn to GoFundMe, Schelling said, which allows them to raise money from their friends and family.
Some people also organize fundraisers; for example, working with local LGBTQ bars to have a percent of one night’s proceeds go toward their surgery. Schelling said he’s seen people in Texas do “plate sales,” where they hold an event and make food, like homemade enchiladas, and sell plates of it to raise money for their surgery. If you get creative with fundraising, he said, and combine it with any savings you do have, you can meet your goals a lot faster.
Explore your insurance
If you have health insurance, read your policy carefully to determine what types of transition-related care is and isn’t covered. If you’re not able to figure it out, call your insurer or ask your job’s human resources team to help you understand your coverage.
Be aware that under the Affordable Care Act, health insurers and medical providers are not allowed to discriminate against you because you’re trans. While this doesn’t mean they have to cover every procedure, an insurer cannot categorically exclude transition-related care, and providers aren’t allowed to deny you care simply because you’re trans — though unfortunately it sometimes still happens.
If you have faced discrimination from an insurer or medical professional, you can file a complaint with the U.S. Department of Health and Human Services. If you need assistance, contact The Transgender Law Center Legal Helpline or call (415) 865-0176 x306.
If you’re on Medicare, know that transition-related care that’s deemed “medically necessary” is supposed to be covered. However, attempts to get surgeries covered by Medicare are not always successful, so ask your doctor about their history with the program and whether or not previous claims have been accepted.
Consider borrowing to help cover the costs
If you’re not able to pay for transition-related costs with savings, you might be able to finance them with one of these options.
Credit cards. Credit cards offer an easy way to borrow funds. Your credit limit might not be enough to pay for an entire major surgery, but it could cover smaller procedures or miscellaneous costs. If your credit card’s interest rate is high, many credit cards offer 0% interest rates for a year or longer, giving you time to make a dent in your debt. If you go that route, just make sure that if you carry a balance, you can handle the payments once the regular APR kicks in. Also keep a lookout for annual fees, and be aware that carrying a high balance can hurt your credit score since it increases your credit utilization ratio.
Personal loans. Another option to pay for transition-related costs or surgery is taking out a personal loan, which gives a lump sum that’s then repaid with interest in fixed payments. You can take out a personal loan from a traditional financial institution, like a bank or a credit union, or from an online lender. Personal loans are typically available anywhere from $1,000 to $50,000, and interest rates vary significantly depending on credit history.
Medical financing. There are also certain financing options specifically for medical expenses. One is CareCredit, a medical credit card accepted by some healthcare providers. CareCredit often offers 0% interest for certain time periods, but if you don’t pay off your balance by the end of that predetermined “promotional period,” you will owe interest retroactively, and at a very high rate. CareCredit should only be used if you know you can pay off your balance in full before interest kicks in. Another option is Prosper — the company known for peer-to-peer lending also offers a special type of healthcare loan in partnership with some doctors. If your doctor uses their system and you’re approved, you can get a loan for up to $35,000 with no retroactive interest.
Find extra work
Another way to help pay for transition-related expenses is to supplement your income. Consider turning to the gig economy, where you can give rides, deliver groceries, charge scooters and a number of other flexible jobs.
Schelling said he’s even encountered many trans people who work at Starbucks for several years. This offers a unique opportunity, he said, since it not only brings supplemental income, but Starbucks also offers extremely trans-inclusive health insurance, even to part-time employees.
3 ways to save on transition-related expenses
Find free clothing
Some trans people slowly start building their new wardrobe over time, but others don’t start purchasing attire that matches their gender identity until they begin socially transitioning. This can get expensive quickly — not to mention, many transitioning people are uncomfortable shopping in public, Schelling said.
One way to get around this is to participate in or start a clothing swap with other members of the trans community. Some organizations put these together, but if there’s nothing in your area, try to organize one yourself. Have everyone bring some clothes they no longer wear, and swap them with those who are now looking for those types of clothes. People can also bring shoes, jewelry, bags, makeup and other items they no longer need.
“In the city next to me, there was a group of trans people who were doing that,” Sallans noted. “They were collecting binders and clothes and giving it out to people when they had a social group meeting or peer support meeting.” Beyond the immediate need, he added that it also helps build a sense of community.
If a clothing swap isn’t an option for you, consider visiting local thrift stores or online marketplaces like Thredup or Poshmark to find gently used clothes at a huge discount.
Schelling added that some organizations and businesses offer free chest binders for trans people who can’t afford one. For example, Point of Pride offers a free binder program.
Look for LGBTQ-friendly healthcare
Many trans people seek out hormone replacement therapy, but if you don’t have health insurance, accessing HRT and any other basic healthcare needs can be extremely expensive. Fortunately, more and more LGBT-focused clinics are currently opening up around the nation, according to Sallans.
“There are different non-profit organizations that can subsidize costs, whether you need access to hormone therapy or general prevention care, like reproductive and sexuality care,” he said. Planned Parenthood is one such organization, he also noted; while not every location offers hormone replacement therapy, many do.
There are also individual clinics, like Kind Clinic in Austin, Texas, that focus specifically on healthcare for the LGBTQ+ community and offer discounted services.
Schelling’s organization has also observed the increase in clinics that offer trans healthcare.
“A lot of times, the upside is there’s access to competent medical care, and some of those clinics assist you with the costs of your medications,” he said. “The downside is that usually there’s a limited amount of days or evenings these clinics are open, so once people find out, the wait list can be two to three months out.” However, he noted that if you’re looking for hormone therapy, once you have your initial blood work completed, you typically only have to go in every few months.
Access free or discounted legal assistance
If you want to legally change your name and/or gender marker, you’ll have to go through your legal system to get new IDs. “Having people who are knowledgeable in this process is extremely important since it can be extremely overwhelming and expensive,” Sallans said. While using a lawyer for this is optimal, especially since laws vary by state, it can be expensive. Sallans said he did his all himself, which was much cheaper, but it was also very daunting.
Across the country, there are law clinics that offer free legal services for name and gender marker changes. For example, in San Antonio, Texas, the local LGBTQ center, The Pride Center, provides free legal gender and name changes through a legal clinic with a local law school. If there’s a law school near where you live, find out if there are any law clinics or programs available to help.
Some individual lawyers also offer free or discounted services for transr members of their community who have these legal needs. If you’re not sure where to start, and your city has an LGBTQ chamber of commerce, see if any lawyers are members. If there are any LGBTQ publications in your city, see if any lawyers advertise in them. Sallans says some nonprofits also offer these legal services for free in various areas.
Transitioning can be an expensive endeavor, but there is an ever-increasing number of resources and organizations available to help make the process more within reach.