Top Tips on How to Pay for Gender Reassignment Surgery
Are you thinking about how you could afford to pay for gender reassignment surgery? You are not alone: in the UK, an increasingly tolerant and accepting climate means that more and more people are feeling free to explore their gender identity. Trans issues and the existence of queer, non-binary and non-gender conforming people of all persuasions have finally reached the mainstream. This is thanks, in part, to the work of numerous trans rights activist and famous celebrities, such as Caitlyn Jenner and India Willoughby, who have been brave enough to publicly describe their own transition surgeries in detail.
For some people, transitioning means identifying as a gender that is different to that which they were assigned at birth. Some trans people may feel that gender reassignment surgery is ultimately necessary so that they can live a life that they feel is true to their innate sense of identity. In recognition of this, the procedures are sometimes referred to as gender confirmation surgery.
Becoming the person you truly are, has, in many ways, never been easier, despite the fact that many trans people continue to face extremely high levels of discrimination and aggression. And one barrier, which many trans people face, is the financial aspect of the transition process. There are many hidden expenses which can have a detrimental impact on someone trying to be honest about their true self. This article will explore the costs of gender reassignment surgeries in the UK and ways that these can be funded.
What exactly is gender reassignment surgery?
Gender reassignment surgery or sex reassignment surgery is an umbrella term given to a number of procedures that aim to realign a person’s physical characteristics with their internal sense of gender. It is often the end of a process of transition that begins with superficial changes, such as clothes, makeup and hair and continues with hormone therapy.
Someone who has always felt like a woman, for example, but has the physical characteristics of a man, might opt for surgery to remove male biological features and have surgeries giving them more stereotypically feminine features, such as breasts and a vagina. A woman identifying as a man can also have surgery and treatment that will help them to look like a man.
It is important to note that for many trans people, surgery is not part of their journey, and surgery should not be undertaken lightly, not least because of the significant risks and side-effects, as with any surgical procedure. In the UK, gender reassignment surgery is only an option for those who are over 18 and pre-surgery counselling is also a requirement.
The different types of surgical procedure for gender reassignment surgery
- Male to female surgery
- Male to female surgery is easier and more likely to be successful and for this reason is considerably less expensive than female to male surgery than involves highly challenging constructive techniques.
For many male to female trans people, the main surgical treatments are:
- Phallectomy (removing the penis)
- Orchiectomy (removing the testicles)
- Vaginoplasty (where a surgeon creates a vagina)
- Breast implants
- Labioplasty – the creation of labia
Other popular surgical treatments include:
- Chondrolaryngoplasty – this is a shaving of the part of the trachea commonly known as the Adam’s apple, making it less pronounced and less visible.
- Vocal Folds Shortening and Retrodisplacement of the Anterior Commissure’ ( VFSRAC) or voice feminisation surgery – this surgery alters the voice box resulting in a voice that is higher pitched than a man’s.
- There are also many types of facial reconstruction surgeries that modify strongly masculine bone and cartilage structures. These are not usually available on the NHS.
Female to male surgeries include:
- Phalloplasty – the construction of a penis. This sometimes involves the constriction of a ‘neophallus’ using tissue from sensitive parts of the body such as the inside of the elbow that allow a feeling of sexual sensation. Extending the urethra to stretch through the entire penile shaft to ideally permit urination whilst standing up is considered by many surgeons to be the most challenging part of the surgery.
- Mastectomy – the removal of the breasts
- Scrotoplasty – the creation of realistic scrotum
Some transmen also want surgery that removes all aspects of their female biology:
- Hysterectomy – the removal of the womb
- Oophorectomy – the removal of the ovaries
Do people sometimes regret their gender reassignment surgeries?
Transition is often a fraught process and it is not uncommon for trans people to lose their friends and family and sometimes even their jobs. There are many stories of people who regret their ‘bottom surgery’ on the internet but statistical evidence suggests that this is relatively rare. People who wish to undergo gender reassignment surgery need to be aware that it isn’t a panacea for the problems caused by the underlying condition of gender dysphoria, although it may well help to alleviate many of the symptoms.
How much does gender reassignment surgery cost?
The costs of transitioning vary enormously. For some people, the act of changing their gender on their passport and driving license may be enough which costs under £100 in the UK. No surgery is involved in these cases.
Other may be happy with basic gender reassignment surgery, while others feel the need for repeated surgeries before they can feel comfortable in their new bodies. Costs can range from £10,000 to £100,000.
Is it available on the NHS?
The good news is that gender reassignment is available on the NHS but the bad news is that there are often long waiting lists, depending on the demand in your area. The average waiting time for sex change therapy for an adult is approximately 9 months -and this is just the start of the process. In the UK, it is considered good practice for individuals to receive counselling for at least two years before any surgery. Receiving hormone therapy for at least six months is also usually a given. However, this is not set in stone and there are exceptions to every rule. If a trans man, for example, is suffering health issues caused by breast binding, surgery may be offered as an alternative to hormone treatment.
The first step is to visit your GP and ask to be referred to a gender identity clinic where transgender health services are available. You will be expected to undergo an assessment by a psychiatrist at some point. The healthcare professionals will help you determine whether or not gender reassignment surgery is the right option for you.
Paying for private gender reassignment surgery
Of course, if you can afford the costs, private surgery is significantly quicker. The cost of a straightforward male to female surgery is approximately £20,000, a figure that includes aftercare. Female to male surgery is very expensive and can easily cost more than £60,000. Your private surgeon will discuss the costs prior to the operation.
How to pay for private gender reassignment surgery
If you have decided or are unable to have a sex change surgery via the NHS, you will need to consider how to pay for treatment that costs such a lot of money.
Unfortunately, most UK health insurance providers specifically exclude gender surgery. However, there is one exception. In 2016, Lloyds Health Insurance became the first major UK provider to offer health insurance for employees transgender surgery via pre-existing health care plans on BUPA.
Pros: excellent source of funding if you work for Lloyds
Cons: this is hardly available to anyone in the UK
Credit cards are typically used for smaller purchases but they can be used for this type of expense. If you need to finance a few thousand pounds or cover the remaining amount that a lender wouldn’t loan you, or the card has an interest-free introductory period and you can pay it off quickly then they are a viable option.
Pros: A few cards have zero-interest introductory periods on purchases for up to 21 months.
Cons: Interest rates can vary widely. Your credit limit may not be high enough to fully cover surgery, and having a high balance can hurt your credit.
If you own a house or have another form of collateral, you may be able to apply for a secured loan. This means, however, that if you fail to make the monthly repayments, your home could be at risk. Another option could be to extend your mortgage, but you should seek advice from your a financial advisor as this may not be the cheapest option in the long-term.
Pros: Low-cost borrowing, very quick
Cons: Not a good option for someone with precarious health and employment prospects.
Online Unsecured Loan
Most people in employment can successfully apply for an online unsecured loan. If you can prove that you can meet the monthly repayments, this could be a good option for you. Always read the terms and conditions first and make sure you understand the full amount of interest that you will have to repay over the lifetime of the loan before you proceed. Paul Spencer from loan comparison site Readies says “We know how important treatment plans and surgery can be for those struggling with their gender identity so whilst we would never tell anyone not to do it, it’s generally not a good idea to use loans or any kind of credit for a medical procedure like this. But if you have no other choice then do make sure you can keep up with the repayments. A medical procedure like this can add value to your life to the point where the repayments and interest charges are a worthwhile investment.”
Pros: Affordable and quick
Cons: Expensive in the long-term. If your credit isn’t in great shape, you’ll pay a very high-interest rate too.
If you have an overdraft facility that is interest-free, you may be tempted to max it out for the surgery. However, it’s really important to make sure that you don’t exceed the limit or you be faced with hefty bank charges and fees. If you have a good credit rating, it is possible to extend the interest-free periods by repeatedly switching providers but to do this successfully, you need to be pretty organised and financially savvy.
Pros: Money can be accessed quickly.
Cons: The risk of incurring high interest and expensive fees if you exceed the authorised limit.
Credit Unions are becoming increasingly popular in the UK. They are small community-run organisations that enable people to access low-cost loans and encourage savings. The interest charged is extremely small. To apply for a loan, however, you will first need to make regular savings into your credit union account for a certain period of time, usually from six months to a year. The amount you can borrow is then calculated based on your savings accrued so far. It’s also a very ethical way of borrowing money.
There are several crowdfunding websites that exist to help people pay for all sorts of personal projects, from, fixing a broken car to paying for an overseas trip. If you have a large number of friends and family, why not set up a crowd-funding page?
Simply explain your situation, state the amount you need to raise, add a few pics and hopefully, you should be able to raise some money towards your surgery. Crowdfunding is more likely to be successful if you have a big social media presence and a social circle that is sympathetic to your cause. But more and more people are turning towards it.
Pros: Enlisting the help of family and friends can be a very positive process and it can be an incredibly quick way of raising money.
Cons: You might not be able to raise enough money and it’s also not a good option for shy introverts who aren’t keen on publicity.
Why not enlist the help of your local LGBTQ community and see if they can help you host some fundraising events to raise awareness and hopefully the money for your surgery. Perhaps you could host a fundraising party in your local LGBT nightclub and a portion of the money raised could be used to fund your surgery with the rest going to the organisation.
Pros: Supporting LGBTQ charities, no hidden costs, potentially raising all the money you need.
Cons: The costs vary according to which method you choose.
Thre are many potential sources of funding for your gender confirmation surgery, For more information about what your gender journey is likely to involve, you might be interested in contacting the several transgender support organisations in the UK that may be able to offer additional advice and support, such as gires.co.uk, mermaids.org.uk, and http://www.gender-matters.org.uk/.