Medicinal pains and the cost of being me

Going to the doctors can be quite the experience when your transgender.  Up until I needed to transition I used the same family doctor as my parents and with him being local it was no problem to visit for any random sniffle.  Not anymore though.  The doctor I have to use now is a bit over an hour away, more if traffic is bad in the Pittsburgh area, but I needed a doctor who understood and could handle situations that may arise in the high risk arena of transition. Sadly, this is only a minor cost and inconvenience in the grander scheme of things.   Doctors specializing in transition based care are very hard to find, and when you do find them they are hours or even states away.  Now, let me run a couple numbers by everyone for a minute.  The numbers vary greatly in location so I will use and for my references and numbers I have heard from around different friends.

The low end costs of a transition can range between $40,000-$50,000 dollars.  Ok, now let’s hit you with the fact that some spend $80,000-$120,000 for transition.  Yes, those numbers are real, and they are the normal costs for someone who doesn’t have insurance coverage for transition care. Newsflash, 90% of us do not have that option as it isn’t considered medically necessary. These also go up every year.  For a small break down let’s examine just some of the expenses.
Hormones: My dosages cost an average of $15/month and are covered partially by insurance
Therapy: Average cost is $50-$200 per month for 1-3 years. This must be listed as something other than Gender Dysphoria.  If listed as gender related, it is not covered.
Blood work: Every 6-12 months I have to have levels taken for my safety.  This is not covered and cost me $300 when discounted by the hospital.
Doctors: My copay for a visit is $40 and I need to see him 2 times a year at least.  Add in gas for 110 miles round trip.
Hair removal: My quote for laser hair removal of just my face was $3500 and I have a very light beard that I can shave every three days or so without anyone noticing.  Don’t forget the very light chest hair that wasn’t included in that quote…
SRS: This is also know as Sex Reassignment Surgery. This can range depending on the doctor and also brings consideration to finding a good facility.   I know of 3 surgeons in America that offer this and the closest to me is almost 5 hours away, Thailand is also an option but only a few choose that one. I could not imagine the pain from that surgery tied with a 14+ hour flight.  Average range is $15,000-$30,000.  A friend just had her consult and she has to spend $21,000 for the procedure and $1000 for her two week stay.  No insurance coverage here either.
FFS:  (Facial Feminization Surgery) This is not always required but many need it for their own self esteem.  $5000-$15,000.
Breast: A girls best friend right. If the hormones don’t promote enough change, add another $5000-$8000 to make the girls how they should be.
Voice: Some of us are blessed with an amazingly good sounding voice from the start. Others don’t so they have two options. Voice coaching $1200 average to vocal surgery $6000.  Also surgery is poor at best and many end up raspy or squeaky.
So this is just a small portion of the total cost.  Add in clothes, shoes, jewelry, and other things any female has collected her whole life and we start to get a picture of what financial life is like for a Trans person. Sad that the costs can prohibit many, including myself, from being our true selves. Now let me add one more level more personal to the issues we face.
I have read many stories about Trans discrimination from people in the medical field. The one that has stuck with me the most has happened more than once in America alone. Emt’s on the scene of an accident and one of the victims in Transgender.  In this situation the transgender person died only because the “professionals” did not stop laughing at the woman long enough to administer life saving treatment.  Maybe we can speak about the doctor who refused to treat one of their long term patients because she transitioned, she died later that day because she had a stroke that could have been prevented.  Maybe we can view the therapist who felt that curing a trans person instead of treating them, leading to that individuals suicide.
I will speak for myself though.  Everywhere I go to get treatment I have to list all medications and this includes my hormones. From going to the dentist, emergency rooms, or urgent care I have to either A:) be force to come out again to every doctor or B:) make up an excuse to why I’m taking estrogen. Mood stabilization was my go to for a while but after I decided to quit hiding I realized that many in the medical field have no clue or experience with a transgender person.
I had to go to the ER for an abscess tooth a few month back.  I was swollen and in severe pain and after finally getting into the room I was asked about why I was on my hormones. I kindly explained that I was transitioning and after a long confused look on the nurses face she very apprehensively checked my mouth, had a script wrote out, and had me out the door in no time flat.  I’ve never been discharged faster in my life, almost like they tossed me out so I didn’t contaminate the others.  Just imagine the looks I get when bringing my blood work to the check in desk.
So let’s sum this all up for you all.  Medical treatment is poor at best unless you use an educated specialized doctor, your health can be a joke to first responders, and your pain means nothing because your different.  Thousands of dollars to be yourself all while hoping you don’t lose your job so you can afford to pay your bills and support a minimal life.  It is amazing to me that with the costs involved many still think that being transgender is a choice or fetish.  Sadly it is life or death to us and without insurance company’s willing to help with our medical needs we are doomed from the start.  I guess it just weighs on my heart to think that my life is not as valuable as another’s according to insurance company’s and the medical field.  Here’s to another year of using the (wrong) men’s room at work because I sure don’t have $22,000 laying around.

One thought on “Medicinal pains and the cost of being me”

  1. As always, you are well versed and explain situations I’ve never thought about as far as what a transgender has to deal with. Then again, you are my first transgender friend, so I read to better understand. I hope that in your writing, it helps you come to terms with all you have to deal with. Writing has always brought to me a better understanding of my thoughts and feelings! Good for you, Ali!!!


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