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Balancing Finances

In weighing the pros and cons of transitioning, a trans person is mainly concerned with their personal relationships with family, friends, church, and community and how much their gender identity affects their emotional well-being. "If I identify as male/female, how important is it to live that way?" Another aspect of every transition, unfortunately, is money. Money matters because, for some who do not have discretionary finances, making the right choice is critical for paying the rent.  This is a Christian issue too, because Jesus is deeply concerned with how we use our money. 

Go and sell everything you own and give to the poor, and you will have treasure in heaven; then come, follow me.

Too many modern Christians need to learn the hard truths that Christianity really teaches. The heresy is that God gives Christians money to enjoy, but Scripture teaches God gives for the same reason God does anything - to further the Kingdom of God, to nurture good relationships, and to grow us into maturity. But this is neither the time nor the place. Let's simply make the assumption that how we use money is very important and mis-using it is sin. Believing that much, what does the use of money suggest?

Costs of Transitioning

More often money is used as a motivation not to transition and for good reason. Transitioning costs money. Transitioning means different things for different trans people. For some, it involves medical treatment. For some it means hiring a therapist. For some it means changing legal documentation. For others, it means none of these things. Some people will spend more on clothing and toiletries, others will spend less.

Surgery

The most commonly cited is surgery, especially sex reassignment surgery where the shape and function of the genitals are changed through surgery. Some people will choose to only remove tissue. Chest surgery, or mastectomy, is common for people born female where the breasts are removed. A friend of mine who is genderqueer and was born male will have an orchiectomy, simply removing their scrotum and testicles. Gender defenders love talking about SRS because it makes cisgender people the most squeamish.  This is the most expensive because there it is the most invasive, delicate, and most likely for complications. Naturally, cost will depend the particular surgeon and whether medical insurance is provided.  Some rare insurances plans cover the entire amount. Travel costs may also increase cost. Here are some estimates in US dollars, assuming no insurance or travel. 

  • Chest surgery: $1,500-$8,500 (Source)
  • Vaginoplasty (penis to vagina & clitoris): $12,000 (Source)
  • Phalloplasty (vagina & clitoris to penis): ???
  • Orchiectomy: $2,000

Hormones

Related to surgery is hormones. There are basically three types of prescriptions: male hormones, female hormones, and a male-hormone blocker. Again, some people take one of these, two, or none. Every person has both female and male hormones running through their body and needs both to be healthy. In genetic, non-intersex females, the balance is tipped to female hormones and vice versa. A female-bodied person may take male hormones (testosterone) to shift that balance to equalize their balance or shift to the male side depending on dosage. Interesting, female hormones (basically estrogen) will naturally partially convert to male hormones in the presence of male hormones. Thus a transman taking male hormones will have less female hormones than when he started. Male hormones do not work the same way; they will not convert. Thus a genetic-male wanting a female balance of hormones must take female hormones as well as anti-androgens, a prescription which blocks male hormones from taking full effect. Other genetic males will take only estrogen or only anti-androgens. Dosages also depend on the individual's body. If chosen, prescriptions may cost anywhere from $5 to $40 a month.

Therapy

Therapy is another major cost. Therapy is wise for anyone transitioning and most surgeons and hormone prescriptions will require a letter of recommendation from a therapist. Therapy may be free under a health insurance plan or local clinic. Most therapists that specialize in trans people use a sliding scale. For example, across town from me, Howard Brown Health Center gives free counseling for their lowest income bracket. Other therapists may charge as much as $150/hr.

Other

There are many miscellaneous costs to consider as well, including:
  • Legal name change: depending on residence, $0 - 500
  • Changing other legal documents such as birth certificate, driver's license, Social Security card: generally paperwork and a few dollars
  • Changing job for those fired because of status or feeling too uncomfortable
  • Change of wardrobe and accessories: $0 - any amount
  • Personal appearance. In our culture, women tend to spend more money on appearance and men less.
  • Other special surgeries on genetic-males such as shaving the adam's apple, eyebrows, and/or jawline

Cost of Not Transitioning

Few people, the trans community included, talk about how transitioning saves money. The reason for this is an example of the anthropic principle at work: the people qualified and likely to talk about the cost of not transitioning are the people who do not transition; the people who do not transition rarely speak publicly about choosing not to transition and when they do, their genre does not allow for negativity about cisgenderism. In other words, the people who pay the price of not transitioning are silent because they (ex-ex-trans excluded) are in the closet. If they leave the closet they are so busy repressing their feelings that they are unable to speak negatively about their choice. Here's an exception to the silence:

Treatment for transsexualism is cost effective. Even though extremely expensive, it is significantly less than a lifetime of psycho drugs, hospitalizations, and emergency services with no significant or employment to society. With the help of SRS and testosterone, I am beginning to merge society with the desire not only to support myself but to devote myself to the community that carried me for so long. - Nikolas J. McDaniel Transgendering Faith

Case Studies

Let's examine a few trans people who I'm familiar with to see how money affects us.

Ephilei

Where better to begin than myself? I'm genderqueer and have zero interest in any surgery. On and off, I've contemplated legally changing my name and taking anti-androgens but neither is necessary to me and I haven't spent a dime on either thus far. I have seen a couple therapists, but transgenderism rarely comes up. I'd be paying the same money even if I was cisgender. The only thing I have spent money on regarding transition is clothing. It's too late to add receipts, but I estimate I've spent $300-500 on transgender clothing (that is, clothing not ascribed to my assigned gender) over the past decade. Keep in mind, I'm extremely frugal; I frequent thrift shops, sale aisles, and clothing swaps. Of that $300-500, I would have need to spend $200 on additional clothing anyway. Another ~$50 was wasted because I went shopping alone and bought awful items that, had someone with sense gone with me, would have saved me the expense. So my net cost is a measly $50-250. Had I not transitioned, I surely would need much more therapy and $250 would only cover a month more.

John Doe

Now take a good friend of mine who's a transman. He also doesn't intend on hormones or any surgery or changing legal documents. His transition is one where he has physically stayed the same but presents himself differently than before transition.  He doesn't see a therapist either and probably wouldn't if he hadn't transitioned. The only association his transition had with money was saving him money on clothing and the like because he would have paid more for women's things than men's.

Jane Does

I also know transwomen who have taken the more stereotyped path with hormones and surgery and spent the typical $15,000 or so. Who can say for certain, but one of them says she can't find a job because she doesn't pass well and employers won't hire a trans  person. If she's right, that costs her more than all her other expenses combined. 

Jerry

Then consider Jerry Leach who started transitioning but stopped. At an early point, he attempted a self-orchiectomy in an act of desperation. While he succeeded in removing his testicles, he nearly died from blood loss and was hospitalized. The emergency room and other bills must have cost him several thousand dollars more than had he done is properly. He began taking artificial male hormones to replace what his testicles would have created naturally; even without transitioning, he must pay for life-long hormones. Later, he secretly saw psychiatrists behind his wife's back to receive female hormones and SRS for a year and a half. He scheduled SRS but then canceled, perhaps after paying for some or all of it. All this brought him more bills but none of the emotional reward of actually living as his identified-gender. He received counseling from his pastor whom, I assume, did not charge him. It's not possible to know just how many thousands of dollars Jerry spent or if he would have saved money by actually transitioning. He does show that not transitioning has a heavy financial price.

Peterson

Peterson Toscano does not identify as trans, but he attended ex-gay counseling and now identifies as ex-ex-gay or simply gay. He says that after 17 years and over $30,000 on counseling, books, and conferences he still could not live as heterosexual. Had he simply accepted himself as a gay Christian as a teenager, he would have saved all of that money.  Peterson highlights not only the money required by trying not to "transition," he shows you risk wasting it all only to find yourself transitioning later. A transgender equivalent (ex-ex-tarns) is Marissa Dainton, though I don't know of any numbers.

Conclusion

My thesis here was not to show that one decision is more cost effective than the other. Like most aspects of transitioning, that depends on the individual. I want to show you can spend tens of thousands transitioning or you can spend next to nothing and even save money from transgender so-called healing therapy. You could also save money not transitioning, but you might end up spending those same thousands of dollars running from it.

While I promised not to preach, on money, let me make just one point. If, and I believe you should, factor finances into the decision to transition, you must be consistent. To take money into account with transgender but not with the rest of your life is hypocritical. While no American likes to claim they're rich, my $200 or another's $20,000 isn't the difference between life and death. I dare anyone to come to me and claim they have not spent $20,000 on themselves for pure recreation and pleasure. Gender transition is not pure recreation, it is (part of) coming fuller into our true selves. I compare it getting married, working for a non-profit, or parenting children which all cost money. Before finding the specks, let's examine the planks: living in two story houses instead of a single; two cars instead of one; eating out versus rice and beans; cable and internet subscriptions versus the library.  Likewise, to proclaim, "I must transition, no matter the cost!" is as stupid and sinful as claiming, "I must have that sports car, no matter the cost!" As Christians, our highest priority is serving God. Both our gender and our money are resources to do that and must use them harmoniously.  Whatever your philosophy on money, be consistent.

See Also

Financing Transition - TSRoadMap.com has an excellent series on paying for transition. They include everything from surgery to family relationships to philosophies about money.
Pros and Cons - A list of reasons to and not to transition

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