Probably one of the hardest things for a lot of transgender folk is being able to afford the medical bills. For many, they are lucky if insurance will cover their hormones. The rest of the expense is all on them. As I showed in an earlier blog, these costs can mount quickly. I usually pay around $70/hr for electrolysis just to have my face cleared. As I prepare to have my second surgery, I will have to go to another electrologist to have the surgical area cleared as they are experienced and know what the medical center is requiring. (My current electrologist does not do that work.)  It takes a number of sessions spanning years to clear just the face. I will have to travel an hour away to get the other work done.

While insurance still doesn’t cover electrology. I was fortunate in working with my company to get many procedures covered under our insurance. This allowed me to afford my breast augmentation. Hormone Replacement Therapy (HRT) can take you a long way, but after two years, I was still a little light. Given that I have a large frame, I needed a little more up top.

Interesting note on the breast augmentation. My doctor would normally do the procedure in his surgical room in his office. The cost for saline, about $6,500.  Because we were using insurance, that had to be done in the hospital, per insurance requirement. This increased the cost to over $10,000. Once it was scheduled, the hospital was calling for its money before the surgery. Though, if I prepaid, then I would get 10% off. Okay, so $1,600 later, I was scheduled. I am still recovering and still not allowed to life much more than five pounds. For those who don’t know what is involved, they put a slit under each breast and lift the muscle to make a pocket. They then slide the silicone into the pouch they create and then sew that up. Oh right, because it was insurance, got upgraded to silicone also. So it is interesting that due to insurance, the cost of the procedure went up significantly.

Now there are a number of other procedures that you could have done. Some do go for an orchiectomy (removal of testes) for about $4,600. Some will go for Facial Feminization Surgery, which has a myriad of procedures. These are all intended to soften the contours of the face to reduce the masculine aspects. Some will even go for buttocks augmentation to give them fuller hips. Prices for these can range from around $3600 for a tracheal shave to reduce the Adam’s Apple, to $9500 for buttocks augmentation.

None of this is cheap. So, remind me again of how this would be someone’s life choice?

For me, I am happy with my top surgery. I will be glad when the pain subsides and I can lift things again. However, it is so nice to not have to depend on forms to give you shape.  Now to go to Macy’s and get my bra right-sized.

I have initiated the process for bottom surgery. This is going to be a looooong process. As I stated above, first the area will need to be cleared of hair. I have my first appointment next week and then will have to continue for a few months to get everything cleared. In the meantime, I will have to set up an appointment with another counselor. This is, once again, an insurance requirement. Even as adults, we need permission from strangers. They call this gate-keeping. I am a 59 year old woman, I should not need permission. However, I will follow procedure and spend more money so they can write a second letter stating that I need this surgery. I already have the one from my counselor.

Besides the letter from two counselors, I also need one from my endocrinologist certifying that I have been under her care for HRT for at least two years. (It was two years in November.) I just hope that it isn’t like the form she had to fill out to have my birth certificate changed. That took six months for her legal department to okay for her to sign it. Thing is, I have my portal and can download all this information, but they need a letter.

I have a Doctor appointment with my PCP later this month also and he will need to send them his health assessment of me.  So between my surgery and all these doctor appointments, I think I made my deductible this year. Have to start putting money aside for this also. I have a little left in my old 401k which hopefully will cover the copay. We will see.

This next year will be quite the journey. Hopefully things will go somewhat smooth, but I have worked my way through many of the bumps and road blocks thrown in my way. I will be back at First Event in February to give my talk again on Just Owning It. It will be good to see a lot of my friends that I don’t get to see to often.

So it is hard to understand why some people flippantly call this a life choice. For many of us, it is more a life sentence. You will hear many talk about testosterone poisoning, in referencing the damage done to us by this hormone. The cost to reverse what it did can be a serious burden to many. For some, so much so, they take their life. We need to move beyond the ignorance and hate and either have all insurance companies cover these procedures, or get rid of insurance companies and go Medicaid for All with coverage for these procedures. In the current hate and ugliness of this administration, I don’t see that happening. There is hope though. Just as they have successfully transplanted a womb and that woman went on to have a baby, there is hope for the generations to come, that they will be able to one day even know the joy of giving birth. We need to continue to progress!

Thank you for sharing my journey. I hope that I have helped to educate and inform.

My heart to your heart, one heart, one spirit.

“Lady” Emma Morgaine Croft