Financing Gender Surgery
Financing Gender Surgery By Lori Wynn
Real World Advice for Those Seeking Information About How to pay for Gender Reassignment Surgery (GRS)
Financing Gender Surgery is published on TGGuide.com with express permission of the Author, Lori Wynn, webmaster of TGGuide.com. This article and photographs may not be reprinted without permission of the author.
FINANCING GENDER SURGERY UPDATE
This article was originally written fifteen years ago. A lot has changed since then. In recent years, there has been a positive shift toward the inclusion of gender reassignment surgery (GRS) and related treatments in health insurance plans. The tips provided in this article still remain good advice since transgender people still face an array of expenses, some or all of which may not be covered by a health insurance option.
Here are some tips to explore the health insurance options:
Health Insurance Coverage
- Private Health Insurance: Many private insurers have begun to include GRS as part of their covered services, recognizing it as medically necessary rather than elective surgery. Policyholders are encouraged to review their plan’s details or speak directly with their insurer to understand what surgeries and related treatments are covered, including hormone therapy, mental health services, and post-operative care.
- Employer-Sponsored Plans: Some progressive employers offer health insurance plans that explicitly cover transgender-related healthcare, including GRS. Employees should consult their HR department or benefits coordinator to understand their plan’s specifics.
- Affordable Care Act (ACA) Plans: The ACA prohibits discrimination based on gender identity, meaning health plans offered through the ACA marketplace cannot categorically exclude all transgender-related healthcare. Coverage can vary by state and plan, so it’s crucial to research and compare options available in your area.
Medicaid and Medicare
Both Medicaid and Medicare have policies in place that can cover GRS under certain conditions:
- Medicaid: Coverage for GRS under Medicaid varies significantly from state to state. While some states explicitly cover transgender healthcare services, including surgery, others may not. Eligibility often requires documentation from healthcare providers stating that surgery is medically necessary for the individual.
- Medicare: Medicare covers medically necessary procedures, which can include GRS, especially if it’s deemed necessary for the treatment of gender dysphoria. Beneficiaries should consult with their healthcare provider to get the necessary documentation and approval.
- Veterans Affairs (VA) Healthcare System – The VA offers comprehensive transgender healthcare services to eligible veterans, including hormone therapy and mental health services. While the VA has historically not covered gender reassignment surgery, policies continue to evolve, and other support services are available.
Related Article: VA Transgender Care
Public and Nonprofit Assistance Programs
Several nonprofit organizations and public programs aim to assist transgender individuals with the costs associated with their transition, including GRS. These organizations may offer grants, scholarships, or financial aid specifically designed for those who cannot afford surgery on their own. Additionally, they can provide resources and guidance on navigating insurance and public funding options.
Tips for Navigating Funding Options
- Documentation is Key: Regardless of the funding route you pursue, having thorough documentation from medical professionals that outlines the necessity of GRS for your health and well-being is crucial.
- Appeal Decisions: If your insurance claim is denied, don’t hesitate to appeal. Many denials are overturned on appeal, especially with the proper documentation and support from healthcare providers.
- Consult with Experts: Consider seeking advice from legal professionals or advocacy groups specializing in transgender rights and healthcare. They can provide valuable guidance and support through the process.
How to Finance Gender Reassignment Surgery
Lori’s original article begins here. It was written at a time when health insurance coverage for GRS was quite the exception.
One question that I hear over and over again is “how will I be able to pay for my gender reassignment surgery?” I am not a financial planner, but let me give you some real-world advice on this subject. I’ve been there, a pre-op transsexual desperately searching for a way to fund my gender reassignment surgery. I wasn’t wealthy so I had to consider every possible option.
Transition had me leaving a job that paid about $45,000 yearly, which was pretty good money back in the early 1990’s. I simply didn’t have the emotional strength to transition on the job but I respect all of you who can pull it off. I transitioned pretty successfully and I quickly landed a job as a secretary, living full-time and working as a female! But, imagine my shock when I got my first $6.00 per hour paycheck. This wasn’t going to be as simple as I’d hoped. Finances were obviously a major concern for me.
Be Safe with Your Transition
First, I should say that I do recommend following the Harry Benjamin Standards of Care. Following the Standards of Care for gender dysphoria and ultimately completing gender reassignment surgery requires time, patience, perseverance, planning and money. I should also mention that pain tolerance will indeed be helpful. I can’t condone the dangerous practices of acquiring drugs from other countries or from anyone other than a qualified physician. Your life is far too important to take such risks!
Create a Transition Plan
Being a fairly detail-oriented person, I actually approached my own transition as I would any important decision. First, I prepared a detailed plan for my transition which included everything from the anticipated timeline to finances required for successful completion. I also listed the support network of family, friends and helping professionals I would need along the way.
You really have to think outside the box since you’re trying to do something as extraordinary as gender reassignment surgery. Often times I’ve seen people who can’t see the benefit of partial solutions. Your source of funding will probably not come from any one single source. Instead, you are likely to find that you have to combine many different sources of funding to achieve your ultimate goals.
I am going to list some of the resources I relied upon. You may not have access to all of these. You very well may think of some others that I don’t mention here.
My Surgery Financing Options
Health Insurance:
While I was not able to get funding for my gender reassignment surgery, I was able to get help along the way with hormone replacement therapy, psychotherapy and rhinoplasty (nose job). In the case of the hormone replacement therapy, I simply submitted my prescription under my health plan and nobody ever asked any questions (cha-ching!). I presented myself for psychotherapy for depression and anxiety. It was only after we began that the gender dysphoria was discussed. (I really was depressed and anxious, but read between the lines here). My rhinoplasty was for a deviated septum which is a medically necessary procedure (again, read between the lines).
Check you insurance policy to see if it will cover gender reassignment surgery. Although most policies exclude such procedures, some employers policies do allow it. I have heard that the City of San Fransisco, Boing and Intel are among those that provide for gender reassigment surgery for their employees. To date, Medicare does not allow for gender reassigment surgery as they consider it to be “experimental.”
Savings:
I didn’t really have much money in savings, but I started a savings account and added to it as often as possible. Once the money was there I tried really hard not to touch it.
Employment:
I eventually got another job and worked at both for one and a half years to save up money for surgery. Fortunately, I was able to pass well and during transition I worked a daytime and an evening job. I was able to pay the bills and add some money to my savings.
Retirement Accounts:
Cash them in if this is important enough to you. I cashed out a modest retirement account that helped me live without working for six months while I transitioned from male to full-time female. That’s about all it allowed for, but it got me through this period of down-time in my life.
Credit Cards:
It isn’t usually wise to use credit cards for major expenses, but we have to think outside the box. If you can make the payments then my favorite words are CHARGE IT!
Personal Loans:
I did ask some family, friends and even my employer for personal loans. I was fortunate to have some people who believed in me and helped contribute to my surgery fund. This included a generous contribution from my employer.
Loan Companies:
I had fairly decent credit, so I was able to qualify for a couple loans to help with my transition and SRS. These generally carry a high interest rate so be careful.
Home Equity:
Home Equity:If you have a home you are in a great position to generate income by either selling your home or obtaining a home equity loan. Home equity loans generally carry a lower interest rate and therefore are more attractive than some other financing options. You could even rent out a spare room if necessary.
Sale of Personal Assets:
Perhaps you don’t really need that collection of firearms you’ve been collecting since your days in the military. Almost everyone has personal possessions that have value. I sold some of my photography equipment and other personal items. Sure it hurt, but a girl has to set her priorities.
Gender Financing Cautions
Beware of getting so far in debt you can’t pay off your responsibilities, although bankruptcy may be a viable option if you are entering transition with a heavy debt burden. This should only be considered upon sound legal and/or financial advice. So many people enter bankruptcy to pay off minor debt loads that could have been otherwise restructured through consumer debt counseling and payment arrangements.
I also caution against believing that your knight in shining armor will come along. Few of us ever find Prince Charming with both the willingness and the financial resources to bear our SRS expenses. It does happen but don’t lay all your hopes and dreams in what somebody else might do for you someday. It is your life, your responsibility and you can make it happen!
Consider All Reasonable Options
Once again, I caution against thinking too narrowly when considering possible resources. Your solution will most likely result from sound planning and multiple funding sources. Gainful employment is an absolute necessity for most of us who are entering transition. I do not recommend even considering transition until your support network is in place and you have secured employment in your new role. You can then use the income from that employment to pay for the wide variety of expenses that accompany SRS such as electrolysis, prescriptions, clothing, makeup, doctors visits and co-pays, etc.
When choosing employment, if you have the luxury of choosing between different jobs, I would weigh the benefit of any health insurance in the final decision of which employer to choose. Other considerations might include the ability to advance, ability to obtain leave time for SRS, how understanding the employer is toward transgender employees, etc.
I hope some of this helps. I wish all who face gender transition the very best of luck and success.
This article is Published on TGGuide.com with express permission of the Author. All rights are reserved by the original author. Any reproduction without permission is prohibited.