How much does gender reassignment surgery cost? It’s a question gaining relevance for more than just the people interested in pursuing the various procedures for themselves.
Right now, the military, government and other institutions both public and private are increasingly helping their individual members, enlistees or employees cover the expense of what’s called “sex reassignment surgery.” The costs involved in what they’ve signed up for are both high and sometimes hard to grasp.
According to multiple sources, the price of basic genital reassignment surgery (or genital reconstruction surgery) for a man transitioning to a woman ranges from $7,000 for a simple orchiectomy and vaginoplasty to $25,000 for orchiectomy and the more complicated colovaginoplasty. This is often, but not always, followed up by breast augmentation, which can run anywhere from $5,000 to $10,000. That’s a total average high of $35,000, but estimates for the two procedures combined have ranged from $10,000 to upwards of $50,000.
For women transitioning to men, the initial costs can be higher, and the choices more complicated. Some estimates lower-end cost of a metoidioplasty—a procedure that “frees” a hormone therapy-enlarged clitoris from the body for use as a phallus—at $2,000. That said, there are estimates of more complex metoidioplasties, as well as procedures that add testicles and involve full phalloplasties that top $100,000. Often double mastectomies, ranging in cost from $15,000 to $25,000, and sometimes hysterectomies, which run from $7,500 to $11,50o, are performed.
It’s important to note that the lower-end costs above take into account the fact that many candidates go overseas (Thailand in particular) for procedures. There, a long history of competing clinics and other factors keep prices down.
These estimates, however, hide the true totals of gender reassignment. Much of the important work of switching from one gender to another is done hormonally through constant and expensive treatment.
Hormone Replacement Therapy (HRT) costs on average $1,500 a year and candidates for reassignment surgery generally undergo a multiyear course before having any procedure. After surgery, the use of HRT typically continues indefinitely for both male-to-female and female-to-male individuals, as do the payments. Someone who transitioned at, say, 30 and continued to have HRT until, say, 90, could rack up $90,000 in prescription costs (assuming science doesn’t develop a cheaper, more effective solution).
There’s also added cosmetic expense. Before surgery, many male-to-female candidates elect to have electrolysis done to remove the hairs that HRT does not eliminate. As well, many male-to-female candidates also opt for facial reconstruction to make them appear more “feminine” ($25,000 to $60,000). Further, an outpatient chondrolaryngoplasty (the shaving down the male Adam’s apple) can cost anywhere from $2,000 to $5,000.
Our best look at what the total cost for reassignment in the U.S. comes from the Philadelphia Center for Transgender Surgery. Their package deal for a bevy of reassignment procedures for a candidate going from male to female is $140,450. Their package covering female-to-male transition is $124,400. That estimate, however, doesn’t factor in a lifetime supply of HRT, the cost of travel to a chosen clinic, lost work days, and other expenses.
Lots of surgeries in the U.S. are crazy expensive (a simple appendectomy can top 200,000, according to a 2013 report from the White House)—the difference with sex-reassignment surgery is one of coverage. While groups (such as the U.S. military) or insurance companies are increasingly paying out for the various procedures and therapies involved, it’s rare that any of them cover the total bill. For the individual transgendered person, transitioning almost always comes with a considerable finanical burden.