How to Pay for Gender Confirmation Surgery

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September 24, 2024 | 8 min read Financial Assistance

Our self-identity is a big component of our happiness. However, for many transgender and gender nonbinary individuals, gender incongruence between their sense of self and their anatomy can cause significant stress. Medical transition – which might include hormone therapy or gender confirmation surgery – is one of the many steps of the transition process that can help these individuals feel more empowered while alleviating feelings of gender dysphoria. Gender-affirmation surgery used to be called “gender reassignment surgery,” but the shift in the naming better encapsulates the procedure.

Like many medical procedures, this is an intensely personal decision, and it can represent a big step for many nonbinary and transgender people. Transitioning can also improve one’s mental health. However, gender-affirming surgery and other transition-related costs can present a barrier to those who need it. In this article, we’ll dive into the many options you or a loved one have to pay for gender confirmation surgery. To start, let’s better understand gender-affirming surgery costs.

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Gender-affirming surgery options and costs

Gender confirmation surgery is a type of reconstructive surgery that helps a patient’s body conform to their experienced gender. For gender non-conforming and transgender patients, these surgeries can include:

Facial feminization surgery: A variety of procedures that make facial features appear more feminine, including cheek augmentation, brow lift, lip augmentation, genioplasty, or tracheal shave.
Facial masculinization surgery: A variety of procedures that make facial features appear more masculine, including cheek augmentation, thyroid cartilage enhancement, jaw or chin augmentation, nose reshaping, and forehead lengthening.
Top surgery: A variety of procedures that augment a person’s breast tissue to reflect a more traditionally masculine or feminine appearance. These can include breast augmentation, mastectomy, and areola or nipple resizing or repositioning.
Bottom surgery: A variety of procedures that reconstruct the genitalia to better represent the person’s gender identity. These procedures can include genital surgeries such as vaginoplasty, metoidioplasty, phalloplasty, orchiectomy, or hysterectomy.

Costs for these surgeries can vary. According to The Journal of law, medicine & ethics, the average costs for an orchiectomy are around $6,927, $56,269 for vaginoplasty, and $137,893 for a phalloplasty. These costs have a wide range based on the procedures performed and additional factors. Besides the costs of these surgical procedures, additional costs could include:

Consultation fees (if not covered by insurance)
Follow-up appointments
Surgeon’s fees
Operating room fees
Anesthesia fees
Postoperative garments and medical supplies
Travel and accommodation for out-of-town surgeries
Home care assistance during recovery

These costs can represent a significant outlay for the patient. Working with their medical provider, each person should decide what medical transition care options are best for them. Now that you’ve seen the cost of gender-confirmation surgery, let’s look at the ways you can pay for this care.

1. Health insurance

Insurance coverage is one of the main ways many Americans pay for their healthcare. Per Section 1557 of the Affordable Care Act, it is illegal for federally funded health plans (like those from HealthCare.gov) to deny coverage on the basis of gender identity. Therefore, Marketplace plans generally offer some support for transgender-related care.

However, private healthcare coverage (like you might get through an employer) for gender-affirming surgery can vary greatly from one state to another. This is because some insurance policy providers view certain gender-affirming procedures as cosmetic instead of medical necessity, even if your state has protections for gender-affirming care. In these cases, an insurance company may not cover gender-affirming surgery.

To see if your health insurance plan includes coverage or exclusions for transgender health care, you’ll want to read the plan’s explanation of benefits. This explanation will detail if the policy covers gender-affirming care and what the plan will pay for. Take note that you may still have to pay co-pays or deductibles to get this treatment.

In some cases, in order to get gender-affirming care, you must have medical documentation from your medical providers before requesting surgery pre-authorization. To learn what documents you need to submit to your insurance provider and for additional information on coverage, contact them directly.

2. Crowdfunding for gender-affirming care

As you’ve seen, gender confirmation surgery can be costly, even if you utilize insurance or have help from other sources. So to bridge the gap to get the care you need, consider crowdfunding. Utilizing a crowdfunding platform like GoFundMe can help you take the stress out of starting a fundraising campaign, and it’s easy to start one for yourself, a loved one, or a friend. Starting a fundraiser on GoFundMe is free, so you can get the help you or someone you care for needs. Crowdfunding for gender-affirming care is also a great way for you to share your story and discuss how this fundraising can help make a significant difference in your transition journey or your loved one’s transition journey.

3. Personal loans

You can also look to personal loans to fund your medical transition care. You can secure a personal loan from a variety of sources including banks or credit unions, online lenders, and even family members or friends. The premise of all of these loans is the same: you borrow a specific amount of money and then repay the lender that amount plus interest. These loan amounts could be up to $100,000. However, lenders will take into account your credit score, credit trustworthiness, and other factors to determine a loan amount and APR. Keep in mind that online lenders can have higher interest rates than local credit unions.

If you decide to approach a family member or friend for a loan, it’s important to consider the implications of the debt on your relationship with them before deciding to finalize a loan. The stress of having to pay back a family member or close friend may steer you away from this type of loan.

4. Credit cards

Credit cards are another way to cover the costs associated with gender-affirming care. However, credit card interest rates can be very high. To combat these high interest rates, you may be eligible to open a credit card that has an introductory 0% APR. Often, these promotional interest rates last for 14-21 months. It’s important to pay off the balance of your credit card during this period, or you’ll be subject to paying interest on the balance of the card.

If you’re using a credit card to pay for medical expenses, keep in mind that utilizing a high percentage of your credit limit can negatively impact your credit score. Therefore, credit cards may be best for those who are seeking minor surgeries for gender-affirming care.

5. Medical credit cards

Medical credit cards can also help you cover gender-confirmation surgery costs. These credit cards are specifically intended to help you cover medical costs, and work like a regular credit card. While cards like CareCredit offer attractive initial financing options, they defer interest. That means that if you don’t pay off the entire balance of your credit card during the promotional period, you could get hit with steep interest charges on the entire purchase amount, not just your balance.

6. Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)

Medical savings accounts are another funding source for gender-affirming surgery. These tax-advantaged savings accounts allow you to save money and then utilize the money for health-related expenses, including healthcare costs. Keep in mind that FSA funds usually have to be spent in the calendar year that you contribute them, while HSA funds do not have such a cutoff.

7. Home equity line of credit (HELOC)

A HELOC can also be a source of funding for homeowners. This type of credit line allows you to borrow against the value of your home, often up to 85% of the value minus what you owe on the mortgage. Because HELOC interest rates are variable, monthly payments can vary. You’ll also want to consider that HELOCs have closing costs, appraisal fees, and other fees.

8. Payment plans

Depending on your healthcare provider, you may be eligible for a payment plan. These payment plans help you break up large medical bills into more manageable monthly payments. You’ll need to work with your provider to agree to the terms of the repayment plan, including what your monthly costs will be. Be sure to understand the billing charges and any additional fees you incur when agreeing to a payment plan.

9. Grants and scholarships

Many organizations offer financial assistance to pay for gender-affirming surgeries and care. Each organization will have its own application and selection processes for this financial aid. Here are a few of the many organizations that offer support:

Gender-affirming surgery is a crucial part of transitioning for many transgender and non-gender-conforming people. While not all will go through surgery, those who choose to face high costs. However, as we’ve discussed, there are many options to pay for gender-affirming surgery costs. From utilizing insurance to applying for grants to utilizing crowdfunding, you can get the financial support you need.

Ready to start crowdfunding? GoFundMe is ready to help. Create a fundraiser in just a few minutes and start reaching a broader audience to support your fundraising efforts. With GoFundMe, you’re one step closer to getting the financial help you need for gender-affirming surgery.

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