http://www.cnn.com/2015/07/31/health/transgender-costs-irpt/index.html
(CNN)Nicholas Ballou binds his chest each day before leaving his home. It's so tight he often finds it hard to breathe and has gotten lightheaded. Throughout the day, he might touch his chest or adjust the wrap -- a nervous habit. Nothing can be out of place.
Ballou, a transgender male, cannot afford top surgery, which would get rid of his breasts and give him a more male-looking chest. At 23, he has wanted to have this surgery for 10 years, but it's expensive and it's unlikely he'll be able to cover the costs anytime soon.
Caitlyn Jenner's highly publicized and often celebrated transition from male to female is not typical of what most transgender people experience. Jenner said so recently in her acceptance speech for ESPN's Arthur Ashe Courage Award at the annual ESPY Awards ceremony.
"If you want to call me names, make jokes, doubt my intentions, go ahead. Because the reality is, I can take it," Jenner said. "But for the thousands of kids out there coming to terms with being true to who they are, they shouldn't have to take it."
As part of her transition, Jenner reports having completed a facial feminization surgery, hormone therapy and breast augmentation.
Many transgender people transition without surgery. Some say they don't want surgery, or are interested in only some of the medical options available. But many cite the cost of the procedures -- potentially more than $100,000 out of pocket -- and the lack of insurance coverage as a barrier to their transition. Still, they worry about how going without might affect their mental health and safety.
The surgery: What does it cost?
The cost of a transgender person's transition can vary widely, and pricing information is often not available.
Eugene Schrang, a Wisconsin surgeon who specialized in gender reassignment surgeries before retiring in 2007, said most patients paid out of pocket for their surgeries, and it was rare for insurance to cover the procedures. Factors that affect the cost include the number of surgeries people want, where the surgeries take place and what type of insurance they use. They also might incur additional costs for travel, hospital stays and psychological evaluations.
In Pennsylvania, the Philadelphia Center for Transgender Surgery posts cost estimates for different procedures. Its price list mentions estimates of $140,450 to transition from male to female, and $124,400 to transition from female to male. This list, unlike many others, includes potential costs for things such as anesthesia, hospital stay and each of the potential surgeries that someone transitioning from one gender to the other may want or require. These numbers are based on one surgery center though, and will change depending on factors such as insurance, the hospital that is attended or if someone is using a different surgery center altogether.
