#FinancialFebruary: The Cost of Transitioning

by Drew Adams

Editor’s Note: Financial February is sponsored by our partners at State Farm.

There are millions of transgender people in the United States. A recent study even showed that one out of 50 teenagers identifies as transgender. Trans people exist across all walks of life, all races, and all creeds. They also cross all the socio-economic levels of society, and that can mean unique challenges when it comes to those who decide to medically transition (hormones, affirming surgeries and other transition-related care).

Not all transgender people decide to medically transition. It’s a personal decision for everyone, but for some, it’s a life-or-death situation as affirming medical treatments might be needed to treat crippling dysphoria. For those who do decide to pursue trans-related medical care, procedures can range from hormone treatments to complicated surgeries, and the costs can fall anywhere from inconvenient to prohibitive. Not all insurance companies cover affirming procedures — some cover a portion of the costs, but not all. Others may deny coverage until the patient appeals, which makes more stress and paperwork. On top of that, trans people are more than twice as likely to live in poverty in the US than cisgender people, and they’re also more likely to be uninsured or underinsured, making medical care even further out of reach.

What options does a transgender American have for paying for affirming medical treatment? There are a few options available, but of course, these options vary widely depending on each individual’s financial situation, employment, family support, and other factors. It’s important to remember that, no matter how impossible it may seem to come up with the funds needed for treatment, things can change, and giving up should not be an option, at least not forever.

Here are some ways you might pay for transition-related health care:

  1. GoFundMe/YouCaring/Other Crowdfunding Sites — This is one of the most obvious and commonly-used methods to raise funds for a variety of causes, including transgender medical treatment. It gives you a way to spread the word about your needed care and encourage friends and family to help. You have to be 18 to start a campaign on these sites, so keep that in mind. There are also a few downsides to these methods: Some sites won’t let you keep any of the money unless you meet your goal, some sites keep a cut of the earnings, and most medical crowdfunding campaigns don’t raise the full amount they’re trying to raise. But if you have a big friend group or a strong social media presence and can get the word out about your campaign, this might be the fundraising path for you.
  2. Grants from Helpful Organizations — There are several nonprofits and other groups out there that basically provide free money for trans health care. The funds don’t have to be paid back by the recipients. The problem is, of course, that there are always more applicants than available funds. The application process varies between organizations, and sometimes, it’s a complicated process with lots of hoops to jump through. If you want to try this route, check out PointofPride.org, JimCollinsFoundation.org, CKLife.org, or Google for other groups that may be local to your area.
  3. Loans — There are many loan types to choose from if you want to go this route. You could get a personal loan from a bank or credit union, you could borrow against your home (if you own a home that has equity) with a home equity loan or line of credit, you could check out online lenders (like Marcus, Earnest, Prosper, Best Egg, Lending Club or others) for an online personal loan, you could get a personal loan from a friend or family member, or you could even use a credit card. The biggest issue with these methods, of course, will be the terms of the loan. What is the interest rate? What is the monthly payment, and how long will it take to pay off? What are the penalties for late payments? It’s very important that you do your homework thoroughly before borrowing money from any individual or institution. Some places charge a fee just to apply for the loan in the first place. Try to avoid payday lenders and other predatory loan sources that have astronomical interest rates and fees. How much money you will qualify for depends on factors like your credit score and income. Be smart with debt and careful not to bite off more than you can chew with monthly payments!
  4. CareCredit — CareCredit is basically a credit card, but it’s used just for health care costs. You may have seen a brochure for CareCredit in your local doctor’s office. I know at least two trans guys personally who used this method to finance their top surgery, so it’s definitely a viable option. As with any credit method, there are potential pitfalls: The interest rate can be high, your doctor has to be one of the ones that takes CareCredit in the first place, and your credit score and income matter in determining your eligibility, of course. But if you don’t have the money for a procedure up front and you don’t have another outlet for a loan, this may be a good choice.
  5. Start a Small Business — If you’re crafty or have a particular skill, you can try to market that to raise some funds! Many online storefronts at sites like Etsy are created by trans folks selling artwork or other creations to pay for medical costs. You could paint, draw, sculpt, write, or create unique products that others enjoy. The biggest challenge is coming up with something to sell; after that, the next challenge is growing the business fast enough for the revenue to matter. If a shop earns just $100–200 a month, it could take a very long time to raise the thousands or tens of thousands of dollars that some transition-related medical procedures can cost, especially if the hosting site takes a cut (which Etsy does).

No matter what funding path you take, remember that new options are emerging all the time. You can talk to your local LGBTQ outreach center to find resources close to home, or you can reach out to national organizations for leads. If you already have a doctor lined up for the care you want, talk to their staff about how other patients pay for their procedures, since that might give you a lead on some fundraising options. Stay positive! You are valid no matter what medical transition steps you take. Good luck!

About the Author:

Drew Adams is a transgender high school senior from Ponte Vedra, FL, who is committed to LGBTQ advocacy at the local and national levels. He serves as his high school GSA’s president and raises money for Northeast Florida’s LGBTQ youth outreach, JASMYN, to which he also donates food, toiletries and school supplies. Nationally, Drew serves as a youth ambassador and advocacy volunteer for The Trevor Project, a youth social media ambassador for the Matthew Shepard Foundation, and a Volunteer and Intern Coordinator for Point of Pride. On the legislative side, Drew lobbies for the Equality Act by visiting with his Congressional representatives and their staff.

Additionally, Drew has spent years fighting to change his school district’s bathroom policy to be trans-inclusive, and the fight is still ongoing. Drew is an International Baccalaureate student and a volunteer at the Mayo Clinic, and he hopes to go to medical school and become an adolescent psychiatrist specializing in transgender health. For fun, he practices Brazilian Jiu-Jitsu, creates sculpture art and plays the piano.