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Paying for gender transition: My own costs and goals

My whole plan in doing this website is to write the book I wish someone would have handed me when I started.

I did these exercises kind of intuitively, long before I wrote this up. Now that I’ve got it laid out as a plan, I think I would have been better prepared for some of the costs. I hope my example helps you go on to plan the last two exercises more realistically than I did.

My values

Topping my A list were:

  • image/personal appearance
  • eliminating debt
  • community service
  • friends

These are the things I find most important. I felt that if I couldn’t pass in jeans and a sweatshirt with no makeup that I wouldn’t be satisfied. In fact, it was not until I realized that this could actually be accomplished that I dared dream of actually transitioning. I felt, based on my world view, that passing would make a huge difference in the quality of my life. I still feel that way today, even though I currently choose to be out.

I also felt that debt was very limiting. I had about $25,000 in college and grad school loans to deal with at the time, and I hadn’t even started transition. Debt would force me to take and keep jobs I didn’t really like in order to pay my bills. I felt if I didn’t have debt, I’d be much more free to live spontaneously. This became my first huge dilemma. The things I wanted to do in order to pass really well would require much more money than I had available. Was going into debt worth passing really well? I thought long and hard and decided it was. I decided that passing well was tied in with my ability to keep my job, so it became a circle: I needed a job to pay for passing well, and I needed to pass well to keep my job. Believe me, I thought long and hard about all of this over many months.

Community service and friends had minor financial components, but they really didn’t figure into the larger financial issues.

My dreams

When I started, these were my dreams (in no order):

  • To get started before I was 30
  • To keep my job through transition
  • To get electrolysis done as soon as possible
  • To “pass” as well as possible
  • To fix my hairline and grow my hair out
  • To start therapy and hormones
  • To get cosmetic surgery to help me “pass”
  • To get vaginoplasty and labiaplasty
  • To get my voice “passable”

My net worth

My assets consisted of a computer, two cats and some apartment furniture. I still used milk crates for a nightstand. My liabilities included $25,000 in student loans. I’d gotten rid of my car, which was saving me a ton. When I figured in my work retirement plan, I was still at a negative net worth. Dag.

My funds available

I figured out that one of my monthly paychecks covered my fixed costs, and the second was available for transition. Now, most people will not have this much disposable income, but that’s why I sold my soul and went into advertising. So, since I’d luckily modified my income years before in hope of paying off loans, I now found that modification would help with transition. Next, I modified my spending significantly. That’s why I have all this time to sit at a computer and type stuff like this. Don’t cost nothin’! My income combined with a very austere spending plan left me with a decent amount of money for transition. Sure, I already had debt, but I decided getting going on transition was more important.

My dreams become goals

When I looked at them, my dreams reflected the enormous importance I placed on passing. However, I wasn’t in an enormous hurry. I felt it was more important to take the time to do things right and to do as much preparation as possible before coming out at work. If I didn’t pass, I wasn’t about to go full-time. So I set up a 3- to 4-year plan. Obviously, you have to decide for yourself what is realistic and comfortable for you.

Some of my dreams (voice, keeping a job) cost almost nothing. My other dreams each required some research. I learned that electrolysis would cost me about $2,000 to $16,000 over one to four years. Everyone told me to start electrolysis as soon as possible, even while you’re still figuring things out. They were right. So, I decided to put that at the very start of my timetable.

After a few sessions, it became clear that my facial hair would take more than the average, and ended up close to $14,000. In my worst month of electrolysis, I spent $1,100, which took up every penny and more I had available for transition. I switched to a different place for electrolysis and saved 40% per hour.

Eventually I settled into a stable pattern of manageable electrolysis sessions that were gradually less each month. Since this was not a big-ticket item in the sense that I had to scrape this all together at once, I just made it part of my budget. Electrolysis money came out of my check at the same time as rent, food, utilities, and savings. I put it among my highest priorities, and I recommend you do too, if passing is your goal. In fact, I decided that electrolysis was more important than saving for transition, so I put all my money available into electrolysis. I decided that I wanted electrolysis done when I went full-time, and I figured I could save for bottom surgery after I went full-time.

Therapy and hormones were like electrolysis and were added to my fixed monthly costs. I was lucky in that my therapist didn’t require me to come very often, and we only did half-hour sessions. Hormones were covered on insurance, less 10 bucks for prescriptions.

My two big-ticket items were facial surgery and genital surgery. I decided that facial surgery was infinitely more important for me than genital work. I felt that everyone would see my face, and that passing would affect everything from keeping my job to walking down the street without being harassed.

After an early error, I got serious about researching cosmetic surgeons, and finally found one after considerable looking. Even though he was more expensive than almost anyone else, I decided getting the very best was important to me. I knew people ho had gone to Mexico and had surgery for considerably less, but many of the results were less satisfactory than I required. I considered facial surgery an important investment I’d see every day for life, so I wanted to be sure it was the best investment I’ve ever made. Turns out, it was for me.

The facial surgery I wanted was too expensive for me to get all at once, so I again prioritized what was most important. I decided my forehead/hairline were essential, as was getting a trachea shave. I scheduled these first. My total costs for these was about $12,600. Plus, these could be done, and if I decided to, I could still stop if I wanted (which I obviously didn’t).

I scheduled the other facial surgery for a year later. It came to about $27,000. I had decided that I would pay for this and bottom surgery with credit cards, so I had begun a strategy at the start of transition to get my credit limit extremely high. Most people won’t have this option, but I did.

Major goal number one: full-time

Once I had the second facial surgery, I was getting ma’amed by almost every stranger I’d meet. So, as I’d planned, I prepared to come out at work at the start of 1998. A work project forced me to postpone for a month until it was completed, which turned out to be perfect timing. The project went well, my value at work was pretty high… I took the plunge and was lucky enough to have it go even better than I’d hoped.

Now that I had a certain income available, I felt confident setting up my bottom surgery.

Major goal number two: bottom surgery

I waited to schedule bottom surgery until I was full-time, and I ended up having it almost a year sooner than I’d originally planned. Because I had done so much preparation for going full-time, and my transition was very smooth, I was able to convince therapists that I was ready. Again, I did this after a lot of thought, and despite the extra costs associated with charging this surgery on a credit card, I have no regrets. I had bottom surgery four months after going full-time.

Major goal number three: dealing with debt

How did I pay for all this? I charged almost all of it. I did this after considerable thought about the consequences. I decided I’d rather finish sooner sooner than it would take to save the money. That meant everything will end up costing me much, much more. But I decided that was worth it.

Obviously, most people are not going to be able to get a $60,000 line of unsecured credit. To be honest, I don’t quite know how I did, either. After the face surgery and bottom surgery, I was trying to stay on top of about $40,000 in credit card debt, plus my student loans. I was paying nearly $850 a month in minimum alone. I knew I could hang on until labiaplasty, but after that I was going to need to do something about this dangerous debt level. I considered bankruptcy but decided the penalty was too great.

I went to Consumer Credit Counseling Service for a consultation and to figure out my options. Their debt management program, using the little calculator, showed me it would take 12 years and cost a total of $82,000 in additional interest to pay off the cards at that rate. That’s right. A total of about $122,000 from 1998 until 2010.

Enrolling in the program and paying the same amount each month reduced my total to under $50,000 in five years. I decided that having an extra $72,000 was worth screwing up my credit rating. I decided to enroll in a debt management program.

I maxed out my last credit card in November 1998, as planned, paying for labiaplasty and a small corrective procedure to my chin. As soon as I got home, I sent off a check to start my debt management program.

I got everything done exactly the way I dreamed, and exactly the way I’d planned. I have absolutely no regrets.


Since my situation is unique (and yours is, too), I present it not as a guideline for your own actions, but as an example of how I thought through some of the things you need to consider. What was right for me may not be right or even possible for you. These last two exercises will be the hardest two, because you will have to make some difficult choices. So, without any more blabbing about me, me, me…

My total costs

I can’t tell you how many letters I got asking how much I spent altogether. That’s a complicated question, and not just because of the adding. Figuring in hidden costs changes my totals, and will affect your own totals.

Well, having said that, here’s the answer, and it even surprised me when I figured it up.

Do not use my 1995 costs to estimate your own costs! Many of these things are now covered by insurance.

Andrea’s total 1995 costs
Hair loss drugs900
Plastic surgery43,355
Total itemized$94,355
Total actual$91,655

Notes on totals

The itemized total is my straight-up costs and does not reflect the additional money I spent on interest by charging some of these services. I estimate this interest total to be about $7,700 with another projected $5,600 in interest to pay off my balances. It also does not include tax refunds of approximately $16,000.

That puts my total actual costs including interest and minus refunds at $2,700 less than my totals, or a final projected cost (less remaining electrolysis) of $91,655.

Notes on itemized amounts

This represents all the transition-related expenses I incurred from April, 1995 through November, 1998. I still have some electrolysis maintenance to do, and I will figure hormones and minoxidil into my fixed costs for life.

My work insurance covered some therapy and prescription costs. These savings are reflected in the totals.

My research is high because internet access was at an hourly rate when I was researching transition stuff. My therapy was about average. My electrolysis was high because I’ve also included some body work I did prior to considering transition, and because I had very heavy facial hair. Voice, hormones, hair loss solutions were about average.

Plastic surgery is what basically doubled my costs above the estimated average. Bottom surgery and legal stuff was all average. My miscellaneous costs were a bit above average from buying some decent work clothes.

If you’d have asked me when I started, I would never have dreamed I’d be spending this much. I hope this helps you think seriously and realistically about your own projected costs.

Again, do not use my 1995 figures to estimate your own costs.

Next: Your spending plan