gender reassignment surgery cost

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• Gender Reassignment Surgery Cost Guide | Price Breakdown

How Much is Gender Reassignment Surgery?

Medically reviewed by Jennifer Richman on October 09, 2024.

Gender reassignment surgery (GRS) is now a less commonly used term in the field of gender-affirming care that refers to surgeries that help transgender patients experience greater gender congruence with their bodies. In this article, we discuss the costs of what some patients call “male to female (MTF)” and “female to male (MTF)” procedures like breast augmentation, chest reconstruction top surgery, facial surgery, body contouring and bottom surgery. We also go over insurance coverage, medical credit and financial assistance resources that help patients reduce the financial burdens of medically necessary gender reassignment surgery.

We recognize that terms like MTF and FTM do not resonate with the majority of the trans, non-binary and gender non-conforming communities we serve. After all, we believe that surgeries do not “reassign” anyone’s gender. Still, many patients that we serve identify with these terms or use them to search for resources and information to help them through transition.

Understanding the Cost of Gender Reassignment Surgery

Below you will find general cost estimates for different gender-affirming surgeries. Generally speaking, these price ranges do not include anesthesia fees, facility fees (staying overnight in the hospital) and/or pathology fees (sending removed organs or tissue for pathology testing). Prices vary depending on a number of factors we discuss below.

Please note that patients who are able to secure insurance coverage for their medically necessary, gender-affirming procedures will not have to pay the full price listed below.

Factors Affecting the Cost

The following factors can determine the price of the gender reassignment surgery or gender-affirming procedure in question.

For instance, surgeons with lots of experience may charge more than a surgeon who is just starting out.

• The surgical technique(s) used are a major determinant in the final cost of surgery. For example, metoidioplasty is a common GRS or masculinizing bottom surgery procedure that we perform. The cost of the metoidioplasty procedure will vary greatly depending on if a patient chooses to undergo a simultaneous primary urethral lengthening procedure, which facilitates urinating standing up.
• At the Gender Confirmation Center (GCC), sometimes chest liposuction is performed as a part of a chest reconstruction top surgery procedure to prevent dog ears and/or help flatten the chest contour. Cash pay patients are never charged extra for chest liposuction.
• Prices for surgery vary depending on the city and country you choose to undergo your operation.
• It is important to ensure that your surgeon is board-certified by the American Board of Plastic Surgery or a similarly reputable organization. This standard is indicative of their extensive training and expertise in plastic and reconstructive surgery.
• Some surgeons will charge a higher surgeon fee depending on their credentials, years of experience, and reputation.
• Facility-related costs include operating room fees, anesthesia fees, and hospital stay, which can vary by location and procedure. Generally speaking, most bottom surgery and facial surgery procedures involve a patient staying one or more nights in a hospital after surgery. Likewise, patients with certain medical conditions may need to stay the night in the hospital after their procedure.
• Prior to surgery, patients will be charged for all postoperative supplies that the surgeon will provide for recovery. This includes bandages, gauze, compression garments and any other materials such as medical-grade dilators for vaginoplasty patients.
• At the GCC, patients are not charged out-of-pocket for follow-up consultations or revision surgeries if they are scheduled within a year after your initial procedure. Not all gender-affirming surgical practices have this policy, so be sure to check with your surgeon.
• Many patients who undergo facial surgery and body contouring elect to undergo lymphatic massages to help facilitate their healing and recovery processes. We recommend that our patients go to licensed, experienced professionals for postoperative lymphatic massages. Since this is an outside service we do not offer, it will be an extra cost to the patient.

Additional Costs and Considerations

• Some patients will undergo revision procedures after their initial gender reassignment surgery or gender-affirming procedure. Occasionally, this is to treat medical complications. In other cases, patients request a revision surgery to correct aesthetic issues. Regardless, GCC patients who undergo a revision procedure one year after their initial surgery will not be charged.
• Most reputable, board-certified surgeons with extensive experience in gender care have a very low revision rate. This means that there is a low percentage of their patients that seek out revision surgeries. It is a good idea to ask your surgeon what percentage of their patients have requested a revision. That said, please note that certain procedures like a phalloplasty or metoidioplasty with primary urethral lengthening have a higher risk of complication than others.
• Individuals traveling to a different city or country for surgery, will incur additional expenses related to travel and accommodation. Many of our patients in the United States and internationally come to the GCC because they do not have access to high-quality gender-affirming surgical care near them. In the case of top surgery, we are one of the few providers in the US that will operate on patients with a body mass index (BMI) between 30-60. We have compiled a free travel guide with tips on how to save money traveling to the San Francisco Bay Area for surgery.
• Recovery from surgery may result in lost wages for those that are not able to get paid time off for the initial stages of healing. While procedures like top surgery and body contouring may only require that a patient take two weeks off work, more intensive surgeries may require more rest time. Likewise, if your job involves heavy lifting, you will not be able to take up that or other vigorous physical activities for at least six weeks post-op. Be sure to check with your surgeon’s office about how much time you will need off work.
• Most gender-affirming procedures do not involve long-term healthcare costs after the initial recovery. Patients who follow recovery instructions closely––for example, the top surgery arm mobility protocol––are unlikely to experience future complications that could result in greater costs.

Insurance Coverage and Financial Assistance

• Insurance Coverage
• Navigating insurance coverage for gender reassignment surgery can be complex, but many insurance providers now recognize these forms of healthcare for transgender individuals as medically necessary and thereby deserving of coverage. We encourage you to look into what your insurance plan covers––i.e., if they have gender benefits––by calling your insurance company and ask what medical policies on gender dysphoria treatment are applicable to your plan. You may also find this information in the Member Handbook provided by your insurance.
• Medical Credit or Financing Options
• The GCC and many other gender-affirming surgical practices do not offer payment plans for after surgery. For example, our patients must pay their full financial responsibility six weeks prior to surgery in order to keep their operation date. For patients that are not able to meet this requirement, we are pleased to partner with Care Credit to help our patients with or without insurance to finance the costs of their surgical procedure. The CareCredit card is North America’s leading patient payment program . The CareCredit card is easy to use, includes no hidden costs, and can be applied towards both surgical costs and follow-up appointments.
• Grants and Financial Assistance
• Through philanthropic partnerships the GCC collaborates with organizations such as Point of Pride , the Jim Collins Foundation and Genderbands because of their developed expertise in assessing need and selecting applicants with high levels of need. Patients still pass through the regular surgical consultation process after they are first selected by the organization. Our clinical team confirms their candidacy for surgery as a second step. Grants from these foundations and others can significantly reduce the costs of surgery for patients.
• Outside of the previously mentioned resource, many trans, non-binary and gender non-conforming communities use crowdfunding and other creative fundraising techniques to help them pay for gender-affirming surgery.

International Surgery Options

Many individuals in the United States choose to travel to other countries for gender-affirming surgery to save on costs. While medical tourism has been a popular option for gender reassignment surgery for decades, it is important to do your research on the credentials, experience and reputation of your provider. Some of the most popular destinations for surgeries abroad include Thailand, Mexico and Turkey. Especially because many countries do not have board-certification for surgeons, patients may need to do extra research to ensure the integrity of their provider. Not to mention, getting surgery outside of the US may involve less legal protections and greater difficulty with post-operative care like revision surgeries. For more information on comparing costs abroad, you can consult this guide .

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Gender-affirming care encompasses a broad range of psychological, behavioral and medical treatments for transgender, nonbinary and gender-nonconforming people.

The care is designed to “support and affirm an individual’s gender identity” when it is at odds with the sex they were assigned at birth, as defined by the World Health Organization.

What is gender-affirming surgery?

Gender-affirming surgery refers to the surgical and cosmetic procedures that give transgender and nonbinary people “the physical appearance and functional abilities of the gender they know themselves to be,” according to the American Society of Plastic Surgeons. It is sometimes called gender reassignment surgery.

There are three main types of gender-affirming surgeries, per the Cleveland Clinic:

Top surgery , in which a surgeon either removes a person’s breast tissue for a more traditionally masculine appearance or shapes a person’s breast tissue for a more traditionally feminine appearance. 

Bottom surgery , or the reconstruction of the genitals to better align with a person’s gender identity.

Facial feminization or masculinization surgery , in which the bones and soft tissue of a person’s face are transformed for either a more traditionally masculine or feminine appearance.   

Some people who undergo gender-affirming surgeries also use specific hormone therapies. A trans woman or nonbinary person on feminizing hormone therapy, for example, takes estrogen that’s paired with a substance that blocks testosterone. And a trans man or nonbinary person on masculinizing hormone therapy takes testosterone.

Gender-affirming surgeries and treatments are the recommended course of treatment for gender dysphoria by the American Medical Association. Gender dysphoria is defined as “clinically significant distress or impairment related to gender incongruence, which may include desire to change primary and/or secondary sex characteristics,” according to the American Psychiatric Association.

Some LGBTQ+ advocates and medical professionals feel that gender dysphoria shouldn't be treated as a mental disorder, and worry that gender dysphoria’s inclusion in the DSM-5 — the authoritative source on recognized mental health disorders for the psychiatric industry — stigmatizes trans and nonbinary people.

How much does gender-affirming surgery cost?

Gender-affirming surgery can cost between $6,900 and $63,400 depending on the precise procedure, according to a 2022 study published in The Journal of Law, Medicine and Ethics.

Out-of-pocket costs can vary dramatically, though, depending on whether you have insurance and whether your insurance company covers gender-affirming surgeries.

There are also costs associated with the surgery that may not be represented in these estimates. Additional costs may include:

Surgeons fees

Hospital fees

Consultation fees

Insurance copays

The cost of psychiatric care or therapy, as most insurance companies and surgeons require at least one referral letter prior to the surgery. An hour of therapy can cost between $65 and $250, according to Good Therapy, an online platform for therapists and counselors. 

Time off work. After bottom surgery, you can expect to miss six weeks of work while recovering. Most people miss around two weeks of work after top surgery. 

Miscellaneous goods that’ll help you recover. For example, after bottom surgery, you might need to invest in a shower stool, waterproof bed sheets, cheap underwear and sanitary towels. Top surgery patients may need, depending on the procedure, a mastectomy pillow, chest binder and baggy clothes.

Is gender-affirming surgery covered by insurance?

It’s illegal for any federally funded health insurance program to deny coverage on the basis of gender identity, sexual orientation or sexual characteristics, per Section 1557, a section of the Affordable Care Act. Section 1557 doesn’t apply to private insurance companies, though, and several U.S. states have passed laws banning gender-affirming care.

The following states have banned gender-affirming surgery for people under 18 years old, according to the Human Rights Campaign: Alabama, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, West Virginia. In four of these states — Alabama, Arkansas, Florida and Indiana — court injunctions are currently ensuring access to care.

And these states have either passed laws — or have governors who issued executive orders — protecting access to gender-affirming surgery, according to the Movement Advancement Project, a public policy nonprofit: California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Oregon, Vermont and Washington, D.C.

But even if your state has enshrined protections for gender-affirming care, some private insurance companies may consider surgeries “cosmetic” and therefore “not medically necessary,” according to the Transgender Legal Defense and Education Fund. If you have private insurance or are insured through your employer, contact your insurance company and see if they cover gender-affirming care. Also, ask about any documentation the insurance company requires for coverage.

The Williams Institute estimates that 14% of trans Americans currently enrolled in Medicaid live in states where such coverage is banned, while another 27% of trans Americans live in states where coverage is “uncertain,” because their state laws are “silent or unclear on coverage for gender-affirming care.”

Because of Section 1557, Medicaid is federally banned from denying coverage on the basis of sex or gender; among the roughly 1.3 million transgender Americans, around 276,000 have Medicaid coverage, according to a 2022 report from the Williams Institute.

How to pay for gender-affirming surgery

If your private insurance company won’t cover gender-affirming care, and you’re unable to obtain coverage through the federal marketplace, consider these sources:

Online personal loan.

Credit union personal loan.

Credit card.

CareCredit.

Home equity line of credit.

Family loan.

There are also several nonprofits that offer financial assistance for gender-affirmation surgeries. Those organizations include:

Point of Pride , which offers grants and scholarships to trans and nonbinary people seeking gender-affirming surgery and care.

The Jim Collins Foundation , which raises money to fund gender-affirming surgeries. 

Genderbands , which offers grants for gender-affirming surgeries and care. 

Black Transmen Inc. , which funds gender-affirming surgeries for Black trans men. 

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Gender Reassignment Surgery Cost (MTF & FTM)

Explore the rising demand for gender reassignment surgery worldwide. Learn about the various procedures and their detailed costs in this comprehensive article.

• Transgender Surgery

Gender reassignment surgery cost varies depending on the type of transition. 

• For male to female (MTF) transition, the cost ranges from $2438 to $6095 and  
• For female to male (FTM) transition, the cost falls between $4876 and $9752 .

When considering the cost of gender reassignment surgery, it's important to note that these figures encompass the surgical expenses alone. Additional costs, such as:

• pre-operative consultations
• post-operative care
• hospitalization may also be involved

For a precise cost estimate that aligns with your specific needs, it is highly recommended that you consult reliable healthcare providers or clinics.

Begin with clarity. Contact us for detailed cost insights now.

There are two broad types of gender reassignment surgery : top surgery and bottom surgery. The top surgery is performed for both people assigned female at birth (AFAB) and assigned male at birth (AMAB). 

• Male to female or non-binary (MTF/N): This procedure entails using saline or silicone implants to boost chest size and form for a more feminine or female appearance. Male-to-female top surgery is done under general anesthesia.
• Female to male or non-binary (FTM/N):  During FTM top surgery, breast tissue is removed and the chest is shaped to give the patient a flat, masculine, or male appearance. Following this, a nipple graft is planted to give a complete look .

Before we discuss each service's cost, let's take a quick look at overall transgender surgery costs in different countries.

You must be curious to know the gender change surgery cost of different surgical procedures. Let's read.

What is the Cost of Male-to-Female Top Surgery?

Breast augmentation or augmentation mammoplasty is another name for MTF and MTN top surgery. 

The MTF/N top surgery or breast augmentation surgery cost in India is around USD 1290 to USD 1940 . The surgeon's expertise and experience are two of the most critical aspects that affect the cost.

For the duration of the surgery, you will be put under general anesthesia. Your surgeon may choose different breast augmentation methods depending on your desired chest size, implant kind, and incision site. The average time for MTF and MTN top surgery is 1 to 2 hours .

The insertion cost and the implant cost are the two components of the surgery cost.

Navigating your options?  Contact us today for more information on cost!

What is the cost of female-to-male top surgery?

An FTM or FTN top surgery procedure takes from   1.5 to 4 hours . Various treatments are performed to get a more flat, masculine, or male-looking chest. Double incision, periareolar, and keyhole are the most popular procedures used by surgeons. 

The FTM top surgery cost ranges around USD 3870 .

Now that we have already discussed top surgery costs, let's take a look at how much mtf bottom surgery costs.

AFAB and AMAB people can undergo bottom surgery as part of their gender confirmation process. Bottom surgery involves transforming or reconstructing the bottom or genitalia. This involves Vaginoplasty, penile transplant , phalloplasty, and metoidioplasty.

What is the cost of male-to-female bottom surgery?

Vaginoplasty surgery is the major procedure performed in bottom surgery . There are three main options under Vaginoplasty. Penile inversion, non-penile inversion Vaginoplasty, and recto-sigmoid or colon graft.

The clitoris is moulded from the head/tip of the penis in all three surgical approaches. The Vaginoplasty cost is around USD 3870 to USD 4520.

Now, let's look at female to male bottom surgery cost.

What is the Cost of Female-to-Male Bottom Surgery?

This procedure involves the removal of the female organs in the lower region and reassigning them to male sexual parts. It includes removing the uterus, vaginal remodeling, labia reconstruction, metoidioplasty, and phalloplasty.

The whole procedure may cost somewhere around USD 5160 to USD 10,335 . 

To get a clearer picture of gender reassignment surgery cost, connect with us now .

What is the Cost of Facial Feminization Surgery?

Facial feminization surgery is a technique that involves changing your facial characteristics to make them appear more feminine. FFS is concerned with bone structure and nose shape. FFS is distinct for each person and can affect any part of the face or neck.

The facial feminization surgery cost is USD 1350 . 

What is Hormonal Replacement Cost?

Hormonal replacement therapy is for both MTF/N and FTM/N transitioning.

MTF/N: The hormones for a male-to-female transition enhance the alignment of your gender identity. It helps induce physical changes in your body produced by female hormones during puberty (gender congruence). Male secondary sex traits can be avoided if feminizing hormone therapy like progesterone is initiated before male puberty. The hormonal replacement therapy cost for MTF/N is USD 12/month.

FTM/N: You'll be administered the male hormone testosterone during masculinizing hormone therapy. It suppresses your menstrual cycles and lowers oestrogen synthesis in your ovaries.  The hormonal replacement therapy cost FTM/N is USD 7/month.

To make a more informed decision, talk to us today.

Factors affecting the cost of gender reassignment surgery:

• Hospital charges:  It depends on the type of hospital you choose. Moreover, the cost also depends on whether you are admitted to a general ward or a private room.
• Psychiatrist : If you need a psychiatrist to deal with your physical changes, your cost will impact you. A psychiatrist is recommended to understand better the complex procedures and adjustments you will need before and after your surgery.
• Clinical Experts and Surgeons : You will discuss the specifics of your gender change surgery with your doctor. It includes an assessment of your medical health status, discussing your long-term gender confirmation goals, and evaluating which procedures may be most appropriate to assist you in your journey. You can ask for specific details such as risks, benefits, and what to expect from the surgery.
• Medical Insurance:  Your medical insurance will play an essential role in the procedure, saving you a lot of money.
• Accommodation Charges:  The accommodation charges are included for international patients.
• Medication charges : These charges include all the medication you will receive before and after the procedure ends.
• Pre- and Post-treatment charges:  The pre-treatment charges include doctor consultation fees, diagnosis charges, etc. The post-treatment charges may include medicine costs, doctor's revisit charges, etc.

Your health is too important to ignore –  schedule your appointment now.

Do Insurance Companies Cover Gender Reassignment Surgery?

Yes, insurance companies that cover gender reassignment surgery! There is no legal prohibition for that. Not all employers provide insurance coverage to unmarried or live-in partners of straight employees. But, several organizations nowadays provide medical insurance to their employees' same-sex partners, including coverage for gender-reassignment surgery.

Some independent companies have made it a goal to try and incorporate this coverage into their medical insurance for employees.  

Note: This article is on the cost of gender reassignment surgery, and data about it is only for your informational purposes and is subject to change.  

1. Side effects of gender reassignment surgery

• Infections.
• Side effects of anesthesia.
• Difficulty in urinating.
• Severe complications in intestines.
• Leakage of urine through openings.
• Closure of vaginal opening.

2. Who typically undergoes gender reassignment surgery?

Gender reassignment surgery is typically undergone by individuals who experience gender dysphoria, a condition where an individual's gender identity does not match their assigned sex at birth. It is usually recommended as a last resort after other treatments such as therapy, hormone therapy, and social transition have been tried.

3. What are the types of gender reassignment surgery?

The two main types of gender reassignment surgery are "top surgery," which refers to surgeries that alter the chest and breast area, and "bottom surgery," which refers to surgeries that alter the genital area. Top surgery may involve a mastectomy, breast augmentation, or breast reduction. Bottom surgery may involve genital reconstruction, orchiectomy, metoidioplasty, or phalloplasty. 4. Do the costs vary for different types of gender affirmation procedures? Yes, the cost can vary based on the specific surgeries involved, such as chest or breast augmentation, facial feminization, or genital reconstruction. References: 

https://my.clevelandclinic.org/

Dr. Josef Hadeed Plastic Surgery | Beverly Hills & Los Angeles (josefhadeedmd.com)

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Transgender surgery – Knowledge gap among physicians impacti... : Current Urology (lww.com)

https://jamanetwork.com/journals/jamasurgery/fullarticle/2779429  

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Question and Answers

I am 27 years i am trans female had a surgery from mtf and now want to have reversal surgery ftm now is it possible in india to have a surgery.

You want to know if there's an option for surgery to change from a trans female to a trans male in India. These surgeries are legal in India, but it is important to first talk to a plastic surgeon who is experienced in gender-affirming surgeries. They will look at your particular case, go over your reasons for reversal surgery with you, and help you with the process. 

Answered on 3rd Dec '24

Dr. Vinod Vij

48! yaşında bir erkeğim trans birey olarak kadın olmak istiyorum Hormon tedavisi istiyorum. Hangi ilaçlardan başlamalıyım

For someone who is 48 years old and seeking to transition from male to female, it's important to consult with an endocrinologist before starting any hormone therapy. They will guide you on the appropriate medications and dosages based on your specific needs. 

Answered on 2nd Aug '24

if I have top surgery without T can I develop pecs if I hit the gym a lot?

If you don't take testosterone or undergo top surgery, you can still build your pecs by lifting weights. Pecs, short for pectoral muscles, can grow with exercises like chest presses and push-ups, which target these muscles. Pace yourself, use the correct form, and be consistent with your workouts. Your pecs can still develop even without testosterone.

Answered on 29th July '24

I'm male and would like to know how to grow breasts without HRT?

Hormones and surgery are the only ways of growing breasts safely. The appearance of women's breasts in some regions is partly dependent on hormones during puberty and pregnancy. Trying to get a larger breast by force can cause some serious medical issues. If you are worried about your body, it's important to talk to a plastic surgeon for safe and honest guidance.

Answered on 17th Nov '24

I am a 32 years old male who has got into cross dressing some 8 years back, now my urge of being like this has grown, last two years I have been I’m eating dian35 prescribed by a doctor in Malaysia, but now I believe I shall be needing more strong dose since the transformation is already 2 years and can see few changes

It seems like you may be going through some changes about turning into the opposite sex. Understand that these changes are complicated and might need some medical interventions. You might require different amounts of hormones to help you through the process. Talk about what is bothering you and your symptoms with a doctor who can help you figure out the best way forward.

Answered on 18th July '24

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Gender Confirmation Surgery (GCS)

What is Gender Confirmation Surgery?

• Transfeminine Tr

Transmasculine Transition

• Traveling Abroad

Choosing a Surgeon

Gender confirmation surgery (GCS), known clinically as genitoplasty, are procedures that surgically confirm a person's gender by altering the genitalia and other physical features to align with their desired physical characteristics. Gender confirmation surgeries are also called gender affirmation procedures. These are both respectful terms.

Gender dysphoria , an experience of misalignment between gender and sex, is becoming more widely diagnosed.  People diagnosed with gender dysphoria are often referred to as "transgender," though one does not necessarily need to experience gender dysphoria to be a member of the transgender community. It is important to note there is controversy around the gender dysphoria diagnosis. Many disapprove of it, noting that the diagnosis suggests that being transgender is an illness.

Ellen Lindner / Verywell

Transfeminine Transition

Transfeminine is a term inclusive of trans women and non-binary trans people assigned male at birth.

Gender confirmation procedures that a transfeminine person may undergo include:

• Penectomy is the surgical removal of external male genitalia.
• Orchiectomy is the surgical removal of the testes.
• Vaginoplasty is the surgical creation of a vagina.
• Feminizing genitoplasty creates internal female genitalia.
• Breast implants create breasts.
• Gluteoplasty increases buttock volume.
• Chondrolaryngoplasty is a procedure on the throat that can minimize the appearance of Adam's apple .

Feminizing hormones are commonly used for at least 12 months prior to breast augmentation to maximize breast growth and achieve a better surgical outcome. They are also often used for approximately 12 months prior to feminizing genital surgeries.

Facial feminization surgery (FFS) is often done to soften the lines of the face. FFS can include softening the brow line, rhinoplasty (nose job), smoothing the jaw and forehead, and altering the cheekbones. Each person is unique and the procedures that are done are based on the individual's need and budget,

Transmasculine is a term inclusive of trans men and non-binary trans people assigned female at birth.

Gender confirmation procedures that a transmasculine person may undergo include:

• Masculinizing genitoplasty is the surgical creation of external genitalia. This procedure uses the tissue of the labia to create a penis.
• Phalloplasty is the surgical construction of a penis using a skin graft from the forearm, thigh, or upper back.
• Metoidioplasty is the creation of a penis from the hormonally enlarged clitoris.
• Scrotoplasty is the creation of a scrotum.

Procedures that change the genitalia are performed with other procedures, which may be extensive.

The change to a masculine appearance may also include hormone therapy with testosterone, a mastectomy (surgical removal of the breasts), hysterectomy (surgical removal of the uterus), and perhaps additional cosmetic procedures intended to masculinize the appearance.

Paying For Gender Confirmation Surgery

Medicare and some health insurance providers in the United States may cover a portion of the cost of gender confirmation surgery.

It is unlawful to discriminate or withhold healthcare based on sex or gender. However, many plans do have exclusions.

For most transgender individuals, the burden of financing the procedure(s) is the main difficulty in obtaining treatment. The cost of transitioning can often exceed $100,000 in the United States, depending upon the procedures needed.

A typical genitoplasty alone averages about $18,000. Rhinoplasty, or a nose job, averaged $5,409 in 2019.  

Traveling Abroad for GCS

Some patients seek gender confirmation surgery overseas, as the procedures can be less expensive in some other countries. It is important to remember that traveling to a foreign country for surgery, also known as surgery tourism, can be very risky.

Regardless of where the surgery will be performed, it is essential that your surgeon is skilled in the procedure being performed and that your surgery will be performed in a reputable facility that offers high-quality care.

When choosing a surgeon , it is important to do your research, whether the surgery is performed in the U.S. or elsewhere. Talk to people who have already had the procedure and ask about their experience and their surgeon.

Before and after photos don't tell the whole story, and can easily be altered, so consider asking for a patient reference with whom you can speak.

It is important to remember that surgeons have specialties and to stick with your surgeon's specialty. For example, you may choose to have one surgeon perform a genitoplasty, but another to perform facial surgeries. This may result in more expenses, but it can result in a better outcome.

A Word From Verywell

Gender confirmation surgery is very complex, and the procedures that one person needs to achieve their desired result can be very different from what another person wants.

Each individual's goals for their appearance will be different. For example, one individual may feel strongly that breast implants are essential to having a desirable and feminine appearance, while a different person may not feel that breast size is a concern. A personalized approach is essential to satisfaction because personal appearance is so highly individualized.

Davy Z, Toze M. What is gender dysphoria? A critical systematic narrative review . Transgend Health . 2018;3(1):159-169. doi:10.1089/trgh.2018.0014

Morrison SD, Vyas KS, Motakef S, et al. Facial Feminization: Systematic Review of the Literature . Plast Reconstr Surg. 2016;137(6):1759-70. doi:10.1097/PRS.0000000000002171

Hadj-moussa M, Agarwal S, Ohl DA, Kuzon WM. Masculinizing Genital Gender Confirmation Surgery . Sex Med Rev . 2019;7(1):141-155. doi:10.1016/j.sxmr.2018.06.004

Dowshen NL, Christensen J, Gruschow SM. Health Insurance Coverage of Recommended Gender-Affirming Health Care Services for Transgender Youth: Shopping Online for Coverage Information . Transgend Health . 2019;4(1):131-135. doi:10.1089/trgh.2018.0055

American Society of Plastic Surgeons. Rhinoplasty nose surgery .

Rights Group: More U.S. Companies Covering Cost of Gender Reassignment Surgery. CNS News. http://cnsnews.com/news/article/rights-group-more-us-companies-covering-cost-gender-reassignment-surgery

The Sex Change Capital of the US. CBS News. http://www.cbsnews.com/2100-3445_162-4423154.html

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

You Won't Believe How Much It Costs to Be Transgender in America

I decided to come out to my family and friends as transgender at 15. At the time I didn't really know what impact that decision would have on my life, but I knew I'd been in the wrong body for as long as I could remember. I didn't quite have the words to articulate my feelings until I found a YouTube of someone transitioning. I realized there was a medical term for the feelings, and that I too could transition to the gender I identified with — I was born a boy, but now I could become a girl.

Luckily, everyone I told was extremely understanding and supportive. My parents took the time to educate themselves on the issue and did everything in their power to make my transition as easy as possible. I was incredibly fortunate to have this foundation of support, as one of the greatest setbacks that transgender teens face is being shunned by families. Many in fact, end up homeless or attempting suicide .

Another frequent setback is the cost of transition. It's a very expensive process, and unfortunately, unlike in other Western countries, healthcare doesn't automatically cover most (or any) of these costs . (Some insurances and employers do, however, and the Human Rights Campaign website has an excellent resource that can walk you through the process.) This makes the prospect of transitioning seem unachievable to a lot of people struggling with gender identity. So how much does it all cost exactly? It depends of course on the desired transition, but here are some of the most popular treatments and procedures, and what they've cost me so far. It should also be noted, however, that no one has to undergo any of the below in order to identify as transgender. This is simply my journey.

Hormone Therapy: $1,500/Year

Deciding to transition into the opposite gender is not a decision that should be taken lightly. I underwent two years of therapy despite knowing in my heart that I was making the right choice. This process was one of the most rewarding stages of my transition. It felt liberating to have a healthcare professional validate my decision and help me understand my feelings on a deeper level. Unfortunately, professional therapy costs thousands of dollars a year, and most trans youth simply can’t afford it. Once my therapist and I decided that transitioning was the right decision for me, I began hormone replacement therapy, also known by its nickname: HRT. It's one of the most powerful tools a person transitioning can have at their disposal. I was initially put on anti-androgens to halt my body’s production of testosterone. This stopped my male puberty right in its tracks, and prevented the development of things like facial hair, excessive muscle, and a deeper voice. Three months later I was placed on estrogen, which was super exciting for me. Soon thereafter my body began to change—my skin became softer, my fat began redistributing itself to my breasts and hips, and my voice started changing. You can’t even begin to imagine how rewarding this process can be for a transgender teenager. Sadly, this incredibly crucial transformation also comes at a price. I had to visit my MD once a month to have my hormone levels checked, and to renew the prescription for my medication. It also costs a whopping $1,500 every year (at least). Once some people complete their gender reassignment surgery, they stop taking this medication, but I'm still on it. I started when I was 16 and am now 25, so that's about $13,500 so far, and I plan to be on HRT for the rest of my life.

Gender Reassignment Surgery: $30,000-Plus

Nearly two years after beginning my therapy and hormone replacement therapy, I was ready for my gender reassignment surgery at 18. In order to have this surgery, most doctors will require proof of at least two years of therapy, as this is not a reversible procedure. They also need to be certain that you're fully aware of the decision that you're making and all of its consequences. For me, it was one of the happiest moments in my life. There are really no words to describe the excitement and anticipation I felt leading up to surgery. I will say, however, that I cannot stress enough enough how important it is to do your research before choosing a GRS surgeon. Only a handful of doctors in the world are truly experts in this field, and choosing the wrong one can lead to catastrophic results. This step in the transition is very expensive, and the average cost is upwards of $30,000. In addition to the actual procedure, you also have to pay for travel costs and hotel accommodations if a good physician does not live in your neighborhood. But in my opinion, this is a small price to pay for a lifetime of completion. I feel incredibly blessed that I had the opportunity at such a young age, and the opportunity to live my life in a way that feels true to me, in part, because of this surgery.

Facial Feminization Surgery: $25,000-$60,000

A year after having gender reassignment surgery, I went back under the knife for facial feminization surgery — a set of reconstructive procedures that alter typically male facial features to bring them closer in shape and size to typical female facial features. In my personal experience, this is the most life changing surgery of them all. As a young transgender woman, nothing was more important to me than being able to "blend" into society seamlessly. It's not only crucial for vanity reasons (what girl wants to look like a boy?), but also for safety reasons. Being trans often subjects you to discrimination, bullying, and physical aggression .

It's so important to members of the trans community that our outward appearance and inner self are in complete harmony. Speaking from personal experience, although not often, I did occasionally come across some level of bullying prior to having FFS. It's simply a lot easier to be singled out and targeted when the aggressor can identify you as being trans. But again, there's a price to pay for the procedure. Board certified surgeons that are qualified to do these procedures will charge anywhere from $25,000 to $60,000 depending on the amount of work you get. Mine cost about $30,000 , as I only opted for the procedures that I thought would benefit me the most at the time, which were forehead and jawline contouring.

Breast Augmentation: $5,000-$10,000

Having a breast augmentation as a transgender woman is an entirely personal choice. I know many who have chosen not to, and instead let their hormones do all the work when it comes to breast development. I chose to have surgery because I wanted a fuller bosom, and my hormones didn't help completely on that front. This surgery will cost between $5,000 and $10,000, and it all depends on the surgeon you choose, where that person is located, and what type of implant you want. Breast augmentation was by far the most painful of all the surgeries. In fact, after all the other procedures, I usually only felt some level of discomfort. When I woke up from this one, it was like an elephant was sitting on my chest.

Looking back at those two years of my life, from about 16 to 19, in which most of my transition took place, I often tell friends that I didn’t feel any less "female" prior to having the surgeries. And I think this is very important. Transitioning simply brought all the puzzle pieces together. I never had a waking moment where I thought in order to feel or be female, I needed to undergo multiple surgeries. My brain, heart, and soul felt 100% female prior to transition. Oftentimes, after surgery, my relatives would ask if I felt any different. My answer was always the same: no. I've always been the same old Elle.

I chose to undergo these surgeries to better my life experience, not to "become" female because I already was. Nowadays, I really only think about the process of transition when I am filming a Youtube video related to it. My journey into the person I am today would not have been possible if that 15-year-old me hadn't stumbled upon someone else going through the same thing. I hope I can help others in the same way.

For more information on transgender individuals and some of the issues and hardships they frequently face, check out the LGBT organization, the Human Rights Campaign .

Related: Trans Teen Wins Right to Use Bathroom of His Choice

Check out Teen Vogue ’s December/January issue cover star, Fernanda Ly.

Thomas Barwick / Getty Images

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Guide to paying for gender reassignment surgery

Not every trans person opts for surgery, but here's what you need to know if you're considering it

Published: June 3, 2021

Author: Elly Belle

Editor: Adriana Ocañas

Reviewer: Antonio Ruiz-Camacho

How we Choose

With queer and trans people constantly under attack from waves of legislation and discrimination directly targeting them, taking a direct stand against the hate is one of the most impactful actions. Pride month isn’t the only time we should be learning how we can do our part to support people…

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With queer and trans people constantly under attack from waves of legislation and discrimination directly targeting them, taking a direct stand against the hate is one of the most impactful actions.

Pride month isn’t the only time we should be learning how we can do our part to support people in the LGBTQIA+ community, including the estimated 1.4 million U.S. adults who identify as transgender,  but it is an opportune moment to take stock and understand their experiences.

See related: Guide to LGBT finances: You can live a richer life

A few important things to understand about sex, gender and trans people

Sex and gender are not the same thing – and gender is often more personal and culturally constructed. While sex is someone’s biological and physiological characteristics, a person’s gender is the behaviors, roles, expectations and activities they relate to in society.

Not everyone identifies with the sex they were assigned at birth, and thanks to more exposure in pop culture and the amplifying of trans people’s voices, people are increasingly starting to explore their gender identity.

Another important thing to know and consider is transgender people exist everywhere and come from all kinds of backgrounds. They come from all walks of life and of all ethnicities and races. And what it means and looks like to be trans will be different for each person, which is why it’s so critical not to make blanket assumptions about transness.

In many places, it’s still dangerous to be openly trans, and not all trans people are even remotely safe to present as who they truly are inside. Wearing the clothing, makeup or other external accessories that make them feel most affirmed and like themselves is not always possible.

For this and many other reasons, it’s important to remember that you can’t tell someone’s gender just by looking at them.

Gender reassignment procedures

Those who want to transition physically or externally have many different options, from getting gender reassignment procedures and buying a new wardrobe and accessories that match their gender, to choosing against surgery.

Trans people can also transition without surgery or medical procedures by changing their clothing, pronouns, name and gender presentation. Either way, money can often be a barrier for trans folks, and getting accurate information about the costs of transitioning can be a hurdle in and of itself.

For those who do wish to get surgery to alleviate gender dysphoria and have a body that matches their gender (and are at least 18 years of age, in most cases), the costs vary significantly depending on details like insurance coverage and location.

Types of surgeries and their costs

The types of surgeries that trans people seek are more informally known as top surgery, which is a reconstructive surgery that alters the appearance of the chest, either taking breasts away for a more masculine/flat chest or adding breasts for those who want to appear more feminine. Top surgeries are performed by a plastic surgeon with training in transgender and gender-affirming medical procedures.

Bottom surgery refers to vaginoplasty, phalloplasty or metoidioplasty, all various procedures that change a person’s genitals to match their gender. Trans women might also opt for facial feminization surgery, so their facial features match how they want to see themselves.

Hormone replacement therapy (HRT) is also a popular mode of transitioning and involves using testosterone or estrogen to reach one’s desired gender presentation.

These methods are not just for binary trans people, or trans men and women, either. Non-binary people and genderqueer people might medically or hormonally transition as well.

The cost breakdown includes:

How to budget for the costs of transitioning

Transitioning isn’t limited to medical costs and procedures. Other things to budget for include post-surgery care or even buying new clothes that match your gender presentation and make you feel affirmed in your identity. It might also include makeup and accessories that help you feel like yourself. And of course, for trans women and transfemmes, much of this will include the pink tax .

Everyday costs

“So far, it’s all been relatively manageable. But I will say that trying to cultivate a wardrobe with gender-affirming looks and clothing has been the most expensive,” says Evelyn, a trans woman who began transitioning within the last half-year. “The biggest thing as a trans woman that has surprised me is shoes. Mainly women’s shoes usually only go up to about 11-12. I have a size 14-15, so most of the time, I would have to order from special stores, or places that custom-make shoes for drag queens.”

Buying new clothing and accessories is not the only option, though. You can do clothing swaps with other trans people, go thrifting or ask friends if they have old clothes they want to get rid of that match your new gender presentation.

Clothing and makeup, despite how expensive they can be, have brought the most joy to Evelyn. “My personality is very extra and outgoing and colorful, and my male-passing clothing always were dull and very narrow fitting. Now, I am buying all these flowy cardigans and scarves and really living my Stevie Nicks meets City girl dreams,” she says.

“I feel so powerful and so happy when I walk around, and the wind picks up my long cardigan and I move with a grace I didn’t think I would ever be able to have.” Despite how much costs can weigh you down, the people who spoke with us explain that transition feels freeing.

Sasha, a Latinx non-binary trans woman who began HRT in January 2020, says that her job in tech and excellent health insurance is what’s made it possible for her to afford transitioning. The most expensive part of her transition, she says, has been hair removal.

“I have spent thousands of dollars on both laser and electrolysis. I looked at my credit card history and to date, I’ve spent $5,003.25 on electrolysis (with probably another $1,500 or so before I’m totally clear of facial hair). As for laser for body hair, I have paid around $3,000 for it so far.”

In total, Sasha has spent about $8,000 just on hair removal, and she says she still has $2,000 or more to go. “This has been far and away the most expensive part of transition because insurance won’t cover it. They will only cover electrolysis for preparation for bottom surgery,” Sasha says.

There are some important things she wishes she’d been told earlier, like the costs and benefits of laser versus electrolysis. While electrolysis is more expensive and takes a longer time, it permanently removes hair. Laser is faster and cheaper but not permanent.

“I decided to go with laser early on in my transition because it was cheaper and seemed to be a good option at the time. For facial hair removal, I would’ve liked to have started out with electrolysis because although it is a slower process, the results are for life. So, I wasted some time and some money on laser for my face early on that I wish I hadn’t,” she says.

Although surgeries and other medical necessities have certainly helped Sasha transition, some of the most affirming purchases she has made in the last few years are accessories that help her feel gender euphoric.

“I bought these leather high-heeled boots that I absolutely love. Playing with makeup is something I always wanted to do and since allowing myself the pleasure, I’ve had so much fun trying different eyeshadows and lipsticks,” she says.

Alex, who has been out as a nonbinary trans woman since 2017, says she’s been most surprised by how quickly transition expenses add up. “They are wildly inaccessible to those without disposable income and require maintenance,” she says of things like budgeting for nail and hair appointments and medspa procedures (like laser hair removal, Botox and fillers).

Legal costs

When transitioning, some people choose to legally change their names and some don’t. The costs can vary depending on where you live. For Sasha, it cost $350 to get a court-ordered name change and publish her name change in a local paper, which is a legally required part of the process.

“I wouldn’t have had to pay that if I had had a legal counsel that guided me through the process of waiving those fees, which is totally possible, but I didn’t know how to navigate it,” she says. Once her name change is official, she’ll also have to pay for copies of the court order.

See related: Major issuers slow to adopt Mastercard True Name card

Social costs

The costs of transitioning are also not simply financial. Trans people who choose to live openly often face discrimination, rejection and even violence. Black trans women and trans women of color face these dangers the most. The risk of being fired from a job, bullied or harassed at work or having to move to an entirely new community because of transphobia is also high.

Some of the social costs of transitioning that Alex says she’s experienced include “ongoing stress and hypervigilance when in public, and exhaustion from being hyper-focused on how I’m being perceived by others.”

However, there are also positive, affirming social experiences that come with transition ­– and that joy is just as important to acknowledge and to be able to look forward to.

The pieces of clothing that Alex has invested in that have made her feel like her truest self include crop tops and big pants, neutral blushes and lipstick and skin tints. And the most affirming experience she’s had related to her transition has been relearning what sex and pleasure feels like in her changing body, she explains.

Options on how to pay

Crowdfunding, loans and credit cards are some of the main ways that trans women who spoke with us said they’ve been able to pay for medical bills.

Like Sasha explained, even if you have insurance or a well-paying job, some costs are just too great, and insurance doesn’t cover everything.

Other options to pay for the numerous costs listed above include:

• Personal loan from a credit union: Although credit unions provide virtually all of the same services and products as banks, their goal is to enable members to borrow at the lowest possible cost.
• Credit cards: A 0% APR credit card may be your best option as many offer introductory APR periods of usually 12 months or longer.
• Home equity line of credit: A  HELOC  is a variable-rate home equity product that works like a credit card – you have access to a credit line that you can draw from and pay back as needed.
• CareCredit: Instead of an open-ended date to pay off your debt (like with a regular credit card), a CareCredit credit card has fixed monthly payments over a set term ranging from six months to 60 months.
• Online personal loan : A personal loan is best for people who may need more time to pay down their balances. You’ll get a low fixed rate that can last for several years.
• Family loan: If a family member is willing to help, make sure to formalize the deal by writing up a contract that includes terms, dates and conditions.
• Crowdfunding: GoFundMe and Indiegogo are great examples of crowdfunding platforms.
• Surgery grants: Point of Pride, Genderbands and The Jim Collins Foundation are all great places to start when looking at this option.

See related: When should you use medical credit cards?

Allyship to trans people

“It is still a very dangerous thing to be trans in the world. I am extremely privileged and due to my job and the resources I have, I can shield myself from many of the hardships a lot of other trans people face. Most trans folks don’t have that luxury,” Sasha says.

The best way to support trans people is to give to them directly, she explains. Donating to transition funds is crucial. “If you see a way that directly supports a trans person’s housing, surgeries, HRT, food, etc., whether that be through a GoFundMe, Venmo, or whatever, if you have the resources, give! Especially to Black and Indigenous trans folks,” she says.

“For cis allies, I challenge you to really listen to trans people. I find that when I speak to cis allies, they do a lot of talking and not a lot of listening. Listen to what trans people tell you about what their experience is like living in this world. It will help you understand how to be a better ally.”

Speaking out against transphobia, sharing your own pronouns and respecting others’ pronouns is yet another important way to support trans people. Doing all these things even when you don’t think there are any trans people to hear it or see it is especially necessary. Because not everyone is able to be or wants to be openly trans, you never know what these actions might mean to someone.

Cis people as well as trans people can embrace their unique gender identities in many ways by “cultivating self-reflective practices that make space for you to think about your gender instead of taking it for granted,” says Alex.

“Everyone, cis or not, has their own relationships to gender. Not all cis people adhere to gender roles in the same way. We are all unique and it’s misleading to think that only trans people divert from gender expectations.”

Even if you’re cisgender, embracing your own unique gender identity and exploring your gender presentation can be eye-opening. Understanding your own gender could help you care more about understanding and respecting other people’s, and stands to give you deeper self-knowledge.

Editorial Disclaimer

The editorial content on this page is based solely on the objective assessment of our writers and is not driven by advertising dollars. It has not been provided or commissioned by the credit card issuers. However, we may receive compensation when you click on links to products from our partners.

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