cost of female to male gender reassignment surgery

Personal Loans

How to afford transgender surgery expenses.

Updated: Nov 11, 2022, 2:00pm

Transgender surgeries—also called gender affirmation or gender confirmation surgeries—are medical procedures you can undergo to affirm your gender identity.

The cost of these kinds of surgeries are often steep, and health insurance coverage for them can vary by policy. “Even if a procedure is covered by insurance, there are still deductibles and out-of-pocket maximums,” said Wynne Nowland, CEO of Bradley & Parker, who transitioned at 56. Surgeries that are solely cosmetic might not be covered by insurance at all.

The good news is that several financing options are available to help you pay for procedures. Some organizations even offer grants and scholarships that can help you afford surgery costs.

How Much Does Transgender Surgery Cost?

The cost of transgender surgery can vary by provider and the type of surgery you choose to get. For a female-to-male transition, masculinization chest surgery (also known as top surgery) might cost $3,000 to $10,000 while chest surgery for a male-to-female transition could cost $5,000 to $10,000, according to Longwood Plastic Surgery.

Bottom surgeries, such as vaginoplasty or phalloplasty, can cost $25,600 and $24,900, respectively, according to estimates from The Philadelphia Center for Transgender Surgery. Additional procedures can increase the transition expenses from there. Aside from the actual surgery cost, other hidden expenses can arise as well.

For example, you could need help at home while in recovery if you don’t have a good support system, according to Nowland. There may also be travel and hotel expenses, which are typically not covered by insurance. Nowland says the best way to prepare for surgery is to reach out to insurance to discuss coverage and plan on saving the funds you’ll need to proceed.

If you’re considering borrowing money to pay for surgery and recovery costs, here are four options to consider.

Related: Does Being Transgender Affect Life Insurance?

4 Ways to Finance Transgender Surgery Costs

Personal loans, credit cards, medical credit cards and home equity loans are products you could use to pay for transgender surgery costs over time. Here’s what you need to know about each:

Personal loans are typically unsecured installment loans that provide a lump sum you can use for almost any legal personal expense, including medical bills. Lenders may offer loans of $1,000 to $100,000. However, your credit and income can affect how much you can borrow and your interest rate.

The average annual percentage rate (APR) for a five-year personal loan is 15.93% as of Sept. 19, 2022, but rates can go up to 36% APR. The good news is that many lenders let you prequalify for personal loans online without a hard credit check , allowing you to shop around for rates and compare costs before borrowing.

Credit Cards

Credit cards give you access to a credit line you can use to cover medical bills. You’ll then pay off the balance over time. While certain credit cards have annual fees, many don’t. Some credit cards even offer an introductory 0% APR for a number of months when you open a new account.

Standard interest applies after the interest-free period, but charging and paying off procedures during the interest-free period could be an affordable way to finance bills. That said, credit cards are usually best for expenses you can repay relatively quickly since interest rates can be higher than personal loans, so maintaining a high balance over several years can get costly.

Medical Credit Cards

Medical credit cards are designed specifically for medical bills and could be a financing option recommended by your doctor’s office.

CareCredit is a popular medical credit card that offers no-interest financing plans of six, 12, 18 or 24 months on transactions over $200. There’s a catch, though: If you don’t pay off the balance during the financing period, interest is charged retroactively from the time of your purchase.

For purchases of at least $1,000, CareCredit offers extended financing terms of 24, 36, 48 or 60 months. The APR for payment plans is fixed and ranges from 14.90% to 17.90%, depending on how much you borrow and the loan term you choose.

Home Equity Loans or Lines of Credit

If you own a house, home equity loans and home equity lines of credit (HELOCs) are ways to borrow from the equity you’ve built up. Here’s how both of these options work:

• Home equity loans: A home equity loan is an installment loan that lets you borrow money in a lump sum, which you could use to cover transgender surgery costs. Homeowners are typically able to borrow up to 85% of home equity, and loan terms can range from five to 30 years.
• HELOCs: These are lines of credit you can draw from and pay down with a variable interest rate. A HELOC could be a better alternative to a home equity loan if you have ongoing costs as it will give you the flexibility to borrow only what you need and pay it back as you go.

The advantage of home equity products for medical expenses is that interest rates may be lower than unsecured personal loans since the collateral (your home) backing minimizes risk for the lender.

However, since your home secures the transaction, you could lose your house if you can’t keep up with loan payments. If the value of your home decreases, there’s also a chance you could go underwater on the house if you end up owing more on your mortgage and loan than the home is worth.

Can You Get Transgender Surgery Grants?

Several organizations offer grants to help cover transition costs, including gender-affirming surgery, which is money you don’t have to pay back. Requirements for grant funding can vary, but in some cases, you need to show that you’ve saved up some money on your own for the surgery to be awarded money. Here are a few examples of organizations offering grants:

• Jim Collins Foundation : The Jim Collins Foundation offers two grants. General Fund grants can cover all gender-affirming surgery costs while Krysallis Anne Hembrough Legacy Fund grants can cover 50% of surgery costs for recipients who match the grant funds awarded.
• Point of Pride : Point of Pride offers an annual scholarship-like program that provides financial assistance for gender-affirming surgery.
• The Loft LGBTQ+ Community Center : TransMission grant funds through the Loft LGBTQ+ Community Center aren’t enough to cover the full cost of surgery. However, grants may be used to help pay for therapy, hormones and other transition expenses.

Compare Personal Loan Rates From Top Lenders

Compare personal loan rates in 2 minutes with Credible.com

Tips to Pay For Transgender Surgery Expenses

As you come up with a plan and explore ways to pay for surgeries, here are a few tips to consider:

• Double-check your insurance policy. Read policy terms carefully and reach out to your insurer to ask about what surgeries are covered. “Like all covered insurance procedures, expect to deal with some red tape, but your patience in doing so will be worth it,” said Nowland.
• Use a health savings account (HSA) or flexible spending account (FSA). HSAs and FSAs are both tax-advantaged accounts designed to help you stash money for medical expenses, which could include gender-affirming surgeries. You can make pre-tax contributions to both accounts from your salary if you set them up with your employer. If you set up an HSA on your own, you can deduct contributions from your tax return.
• Consider crowdfunding. Crowdfunding is when you set up a campaign to raise funds. If you prefer to keep medical procedures private, creating a campaign and asking for donations may not be the right route to take. But if you feel comfortable sharing your story, setting up a GoFundMe or Fundly fundraising page could be a way to cover the cost of your surgeries. Bonfire is another site you can use to fundraise by selling customized t-shirts.
• Get support from family and peers. If you have friends or family able to gift or loan you money, it can be more affordable than taking out a loan from a bank, online lender or credit union.

How to Save Up for Gender Affirming Surgery

Using a combination of funding sources is a strategy that could help you rely less heavily on loans.

Different surgeons charge different fees, so compare prices to project costs. From there, you can determine how much you’ll need to save and by when. If you don’t use an FSA or HSA to save, consider stashing your savings for surgery in a high-yield savings account so your savings earn more interest than it would in a traditional savings account.

Certain savings tools can make setting aside money easier. For example, banks often have recurring transfer features you can set up to automatically move money from a checking account to your savings on a schedule. Plus, savings apps like Digit exist, which can connect to your bank account, use an algorithm to review your cash flow and put spare money away for you automatically. Your savings can grow over time, so you can pay for treatment and surgery as you go.

Get Forbes Advisor’s ratings of the best lending platforms and helpful information on how to find the best loan based on your credit score.

• Best Personal Loans
• Best Debt Consolidation Loans
• Best Bad Credit Loans
• Best Low-Interest Personal Loans
• Best Personal Loan Rates
• Best Debt Consolidation Loans For Bad Credit
• Best Easy Loans To Get
• Best Emergency Loans
• Best Emergency Loans For Bad Credit
• Best Personal Loans For Fair Credit
• Best Installment Loans For Bad Credit
• Fiona Personal Loans Review
• Best Egg Personal Loans Review
• Dave App Review
• LendingTree Personal Loans Review
• Upgrade Personal Loans Review
• LendingClub Personal Loans Review
• LightStream Personal Loans Review
• Upstart Personal Loans Review
• SoFi Personal Loans Review
• OneMain Financial Personal Loans Review
• Personal Loan Calculator
• Loan Comparison Calculator
• Loan Interest Calculator
• Debt Consolidation Calculator
• Pool Loan Calculator
• Simple Loan Calculator
• Boat Loan Calculator
• How Do Personal Loans Work?
• How To Apply For A Personal Loan
• Personal Loan Requirements
• Pros And Cons Of Debt Consolidation
• Personal Loan To Pay Off Credit Card Debt
• How To Find A Co-Signer For A Loan
• How To Prequalify For A Personal Loan
• Compare Personal Loan Options

Today’s Personal Loan Rates: June 25, 2024—Rates Jump Up

How To Finance A Mobile Home

Today’s Personal Loan Rates: June 17, 2024—Rates Drop

SoFi Vs. Discover: Which Personal Loan Lender Is Right For You?

Today’s Personal Loan Rates: June 11, 2024—Rates Increase By 0.10%

Today’s Personal Loan Rates: June 4, 2024—Rates Move Up

Taylor Medine is a staff writer at Forbes Advisor who demystifies complex money topics to help everyday people make more informed financial decisions. Over her nearly a decade of experience, Taylor's work has been published on Bankrate, Experian, Credit Karma, MarketWatch, The Balance and more.

• Credit cards
• View all credit cards
• Banking guide
• Loans guide
• Insurance guide
• Personal finance
• View all personal finance
• Small business
• Small business guide
• View all taxes

You’re our first priority. Every time.

We believe everyone should be able to make financial decisions with confidence. And while our site doesn’t feature every company or financial product available on the market, we’re proud that the guidance we offer, the information we provide and the tools we create are objective, independent, straightforward — and free.

So how do we make money? Our partners compensate us. This may influence which products we review and write about (and where those products appear on the site), but it in no way affects our recommendations or advice, which are grounded in thousands of hours of research. Our partners cannot pay us to guarantee favorable reviews of their products or services. Here is a list of our partners .

How Much Does Gender-Affirming Surgery Cost?

Cara Smith is a lead writer at NerdWallet, where she writes about investing, cryptocurrency and auto loans. She has reported on commercial real estate, housing and general business for Houston Business Journal, CoStar News and other publications. She studied journalism and psychology at the University of Houston, where she served as the editor-in-chief of its student newspaper. She is based in Chicago, where she searches night and day for authentic Tex-Mex in the Midwest.

Rick VanderKnyff leads the team responsible for expanding NerdWallet content to additional topics within personal finance. Previously, he has worked as a channel manager at MSN.com, as a web manager at University of California San Diego, and as a copy editor and staff writer at the Los Angeles Times. He holds a Bachelor of Arts in communications and a Master of Arts in anthropology.

Many or all of the products featured here are from our partners who compensate us. This influences which products we write about and where and how the product appears on a page. However, this does not influence our evaluations. Our opinions are our own. Here is a list of our partners and here's how we make money .

Gender-affirming care encompasses a broad range of psychological, behavioral and medical treatments for transgender, nonbinary and gender-nonconforming people.

The care is designed to “support and affirm an individual’s gender identity” when it is at odds with the sex they were assigned at birth, as defined by the World Health Organization.

What is gender-affirming surgery?

Gender-affirming surgery refers to the surgical and cosmetic procedures that give transgender and nonbinary people “the physical appearance and functional abilities of the gender they know themselves to be,” according to the American Society of Plastic Surgeons. It is sometimes called gender reassignment surgery.

There are three main types of gender-affirming surgeries, per the Cleveland Clinic:

Top surgery , in which a surgeon either removes a person’s breast tissue for a more traditionally masculine appearance or shapes a person’s breast tissue for a more traditionally feminine appearance. 

Bottom surgery , or the reconstruction of the genitals to better align with a person’s gender identity.

Facial feminization or masculinization surgery , in which the bones and soft tissue of a person’s face are transformed for either a more traditionally masculine or feminine appearance.   

Some people who undergo gender-affirming surgeries also use specific hormone therapies. A trans woman or nonbinary person on feminizing hormone therapy, for example, takes estrogen that’s paired with a substance that blocks testosterone. And a trans man or nonbinary person on masculinizing hormone therapy takes testosterone.

Gender-affirming surgeries and treatments are the recommended course of treatment for gender dysphoria by the American Medical Association. Gender dysphoria is defined as “clinically significant distress or impairment related to gender incongruence, which may include desire to change primary and/or secondary sex characteristics,” according to the American Psychiatric Association.

Some LGBTQ+ advocates and medical professionals feel that gender dysphoria shouldn't be treated as a mental disorder, and worry that gender dysphoria’s inclusion in the DSM-5 — the authoritative source on recognized mental health disorders for the psychiatric industry — stigmatizes trans and nonbinary people.

How much does gender-affirming surgery cost?

Gender-affirming surgery can cost between $6,900 and $63,400 depending on the precise procedure, according to a 2022 study published in The Journal of Law, Medicine and Ethics.

Out-of-pocket costs can vary dramatically, though, depending on whether you have insurance and whether your insurance company covers gender-affirming surgeries.

There are also costs associated with the surgery that may not be represented in these estimates. Additional costs may include:

Surgeons fees

Hospital fees

Consultation fees

Insurance copays

The cost of psychiatric care or therapy, as most insurance companies and surgeons require at least one referral letter prior to the surgery. An hour of therapy can cost between $65 and $250, according to Good Therapy, an online platform for therapists and counselors. 

Time off work. After bottom surgery, you can expect to miss six weeks of work while recovering. Most people miss around two weeks of work after top surgery. 

Miscellaneous goods that’ll help you recover. For example, after bottom surgery, you might need to invest in a shower stool, waterproof bed sheets, cheap underwear and sanitary towels. Top surgery patients may need, depending on the procedure, a mastectomy pillow, chest binder and baggy clothes.

Is gender-affirming surgery covered by insurance?

It’s illegal for any federally funded health insurance program to deny coverage on the basis of gender identity, sexual orientation or sexual characteristics, per Section 1557, a section of the Affordable Care Act. Section 1557 doesn’t apply to private insurance companies, though, and several U.S. states have passed laws banning gender-affirming care.

The following states have banned gender-affirming surgery for people under 18 years old, according to the Human Rights Campaign: Alabama, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, West Virginia. In four of these states — Alabama, Arkansas, Florida and Indiana — court injunctions are currently ensuring access to care.

And these states have either passed laws — or have governors who issued executive orders — protecting access to gender-affirming surgery, according to the Movement Advancement Project, a public policy nonprofit: California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Oregon, Vermont and Washington, D.C.

But even if your state has enshrined protections for gender-affirming care, some private insurance companies may consider surgeries “cosmetic” and therefore “not medically necessary,” according to the Transgender Legal Defense and Education Fund. If you have private insurance or are insured through your employer, contact your insurance company and see if they cover gender-affirming care. Also, ask about any documentation the insurance company requires for coverage.

The Williams Institute estimates that 14% of trans Americans currently enrolled in Medicaid live in states where such coverage is banned, while another 27% of trans Americans live in states where coverage is “uncertain,” because their state laws are “silent or unclear on coverage for gender-affirming care.”

Because of Section 1557, Medicaid is federally banned from denying coverage on the basis of sex or gender; among the roughly 1.3 million transgender Americans, around 276,000 have Medicaid coverage, according to a 2022 report from the Williams Institute.

How to pay for gender-affirming surgery

If your private insurance company won’t cover gender-affirming care, and you’re unable to obtain coverage through the federal marketplace, consider these sources:

Online personal loan.

Credit union personal loan.

Credit card.

CareCredit.

Home equity line of credit.

Family loan.

There are also several nonprofits that offer financial assistance for gender-affirmation surgeries. Those organizations include:

Point of Pride , which offers grants and scholarships to trans and nonbinary people seeking gender-affirming surgery and care.

The Jim Collins Foundation , which raises money to fund gender-affirming surgeries. 

Genderbands , which offers grants for gender-affirming surgeries and care. 

Black Transmen Inc. , which funds gender-affirming surgeries for Black trans men. 

On a similar note...

• Type 2 Diabetes
• Heart Disease
• Digestive Health
• Multiple Sclerosis
• Diet & Nutrition
• Supplements
• Health Insurance
• Public Health
• Patient Rights
• Caregivers & Loved Ones
• End of Life Concerns
• Health News
• Thyroid Test Analyzer
• Doctor Discussion Guides
• Hemoglobin A1c Test Analyzer
• Lipid Test Analyzer
• Complete Blood Count (CBC) Analyzer
• What to Buy
• Editorial Process
• Meet Our Medical Expert Board

Gender Confirmation Surgery (GCS)

What is Gender Confirmation Surgery?

• Transfeminine Tr

Transmasculine Transition

• Traveling Abroad

Choosing a Surgeon

Gender confirmation surgery (GCS), known clinically as genitoplasty, are procedures that surgically confirm a person's gender by altering the genitalia and other physical features to align with their desired physical characteristics. Gender confirmation surgeries are also called gender affirmation procedures. These are both respectful terms.

Gender dysphoria , an experience of misalignment between gender and sex, is becoming more widely diagnosed.  People diagnosed with gender dysphoria are often referred to as "transgender," though one does not necessarily need to experience gender dysphoria to be a member of the transgender community. It is important to note there is controversy around the gender dysphoria diagnosis. Many disapprove of it, noting that the diagnosis suggests that being transgender is an illness.

Ellen Lindner / Verywell

Transfeminine Transition

Transfeminine is a term inclusive of trans women and non-binary trans people assigned male at birth.

Gender confirmation procedures that a transfeminine person may undergo include:

• Penectomy is the surgical removal of external male genitalia.
• Orchiectomy is the surgical removal of the testes.
• Vaginoplasty is the surgical creation of a vagina.
• Feminizing genitoplasty creates internal female genitalia.
• Breast implants create breasts.
• Gluteoplasty increases buttock volume.
• Chondrolaryngoplasty is a procedure on the throat that can minimize the appearance of Adam's apple .

Feminizing hormones are commonly used for at least 12 months prior to breast augmentation to maximize breast growth and achieve a better surgical outcome. They are also often used for approximately 12 months prior to feminizing genital surgeries.

Facial feminization surgery (FFS) is often done to soften the lines of the face. FFS can include softening the brow line, rhinoplasty (nose job), smoothing the jaw and forehead, and altering the cheekbones. Each person is unique and the procedures that are done are based on the individual's need and budget,

Transmasculine is a term inclusive of trans men and non-binary trans people assigned female at birth.

Gender confirmation procedures that a transmasculine person may undergo include:

• Masculinizing genitoplasty is the surgical creation of external genitalia. This procedure uses the tissue of the labia to create a penis.
• Phalloplasty is the surgical construction of a penis using a skin graft from the forearm, thigh, or upper back.
• Metoidioplasty is the creation of a penis from the hormonally enlarged clitoris.
• Scrotoplasty is the creation of a scrotum.

Procedures that change the genitalia are performed with other procedures, which may be extensive.

The change to a masculine appearance may also include hormone therapy with testosterone, a mastectomy (surgical removal of the breasts), hysterectomy (surgical removal of the uterus), and perhaps additional cosmetic procedures intended to masculinize the appearance.

Paying For Gender Confirmation Surgery

Medicare and some health insurance providers in the United States may cover a portion of the cost of gender confirmation surgery.

It is unlawful to discriminate or withhold healthcare based on sex or gender. However, many plans do have exclusions.

For most transgender individuals, the burden of financing the procedure(s) is the main difficulty in obtaining treatment. The cost of transitioning can often exceed $100,000 in the United States, depending upon the procedures needed.

A typical genitoplasty alone averages about $18,000. Rhinoplasty, or a nose job, averaged $5,409 in 2019.  

Traveling Abroad for GCS

Some patients seek gender confirmation surgery overseas, as the procedures can be less expensive in some other countries. It is important to remember that traveling to a foreign country for surgery, also known as surgery tourism, can be very risky.

Regardless of where the surgery will be performed, it is essential that your surgeon is skilled in the procedure being performed and that your surgery will be performed in a reputable facility that offers high-quality care.

When choosing a surgeon , it is important to do your research, whether the surgery is performed in the U.S. or elsewhere. Talk to people who have already had the procedure and ask about their experience and their surgeon.

Before and after photos don't tell the whole story, and can easily be altered, so consider asking for a patient reference with whom you can speak.

It is important to remember that surgeons have specialties and to stick with your surgeon's specialty. For example, you may choose to have one surgeon perform a genitoplasty, but another to perform facial surgeries. This may result in more expenses, but it can result in a better outcome.

A Word From Verywell

Gender confirmation surgery is very complex, and the procedures that one person needs to achieve their desired result can be very different from what another person wants.

Each individual's goals for their appearance will be different. For example, one individual may feel strongly that breast implants are essential to having a desirable and feminine appearance, while a different person may not feel that breast size is a concern. A personalized approach is essential to satisfaction because personal appearance is so highly individualized.

Davy Z, Toze M. What is gender dysphoria? A critical systematic narrative review . Transgend Health . 2018;3(1):159-169. doi:10.1089/trgh.2018.0014

Morrison SD, Vyas KS, Motakef S, et al. Facial Feminization: Systematic Review of the Literature . Plast Reconstr Surg. 2016;137(6):1759-70. doi:10.1097/PRS.0000000000002171

Hadj-moussa M, Agarwal S, Ohl DA, Kuzon WM. Masculinizing Genital Gender Confirmation Surgery . Sex Med Rev . 2019;7(1):141-155. doi:10.1016/j.sxmr.2018.06.004

Dowshen NL, Christensen J, Gruschow SM. Health Insurance Coverage of Recommended Gender-Affirming Health Care Services for Transgender Youth: Shopping Online for Coverage Information . Transgend Health . 2019;4(1):131-135. doi:10.1089/trgh.2018.0055

American Society of Plastic Surgeons. Rhinoplasty nose surgery .

Rights Group: More U.S. Companies Covering Cost of Gender Reassignment Surgery. CNS News. http://cnsnews.com/news/article/rights-group-more-us-companies-covering-cost-gender-reassignment-surgery

The Sex Change Capital of the US. CBS News. http://www.cbsnews.com/2100-3445_162-4423154.html

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

• Skip to main content
• Keyboard shortcuts for audio player

• Your Health
• Treatments & Tests
• Health Inc.
• Public Health

Health Reporting in the States

Bill of the month: a plan for affordable gender-confirmation surgery goes awry.

Emmarie Huetteman

Wren Vetens was promised a significant discount on the cost of her gender-confirmation surgery if she paid in cash upfront, without using her health insurance. Yet afterward, Vetens received an explanation of benefits saying the hospital had billed her insurer nearly $92,000. Lauren Justice for KHN hide caption

Wren Vetens was promised a significant discount on the cost of her gender-confirmation surgery if she paid in cash upfront, without using her health insurance. Yet afterward, Vetens received an explanation of benefits saying the hospital had billed her insurer nearly $92,000.

Wren Vetens thought she'd done everything possible to prepare for her surgery.

She chose a doctoral program in physics at the University of Wisconsin-Madison, a school that not only embraced transgender students like her, but also granted insurance coverage for her gender-confirmation surgery when she enrolled in 2016. When uncertainty over the fate of an Obama-era anti-discrimination rule allowed the state to discontinue such coverage, Vetens and her mother, Kimberly Moreland, an OB-GYN, shopped for another plan.

Deducing the procedure would run from $19,000 to $25,000, based on prices posted online, they purchased insurance from Consolidated Health Plans. It would pay a maximum of $25,000 for the operation.

With that information in hand, Vetens planned ahead: She got her insurer's preapproval and scheduled surgery during winter break of her second year, allowing time for recovery before returning to her studies.

Tell Us Your Billing Story

Do you have a medical bill or explanation of benefits that you'd like us to see? Submit it here and tell us the story behind it .

We may use it, with your permission, in one of our monthly features.

So, she was shocked when a hospital representative called her a couple of months before the long-awaited surgery estimating the bill would be $100,000. That meant she would be on the hook for as much as $75,000 after her insurer's $25,000 payout.

With preparations for the surgery well underway, Vetens was feeling overwhelmed with stress. "There were days when I just couldn't get out of bed for a whole day," she said, describing two weeks of panic attacks.

After mother and daughter complained about the last-minute surprise, a hospital representative offered a solution: If they paid out of pocket and in full before Vetens' surgery — forgoing their use of insurance — the hospital would accept just $20,080, assuring them the hospital would charge nothing to Vetens' insurer. But if they did not decide and pay up right away, the surgery would be canceled.

"I certainly felt that I had no choice," Vetens said.

After Moreland gave the hospital her credit card number for payment, they thought the financial roller coaster was over and Vetens could focus on recovery.

Then the bill came.

Patient: Wren Vetens, then 23, a Ph.D. student at the University of Wisconsin-Madison

Total bill: $91,850.20

Insurance payment: $25,427.91

Vetens owed: $13,191.95 (after $20,080 that was counted as a deposit)

Service provider: University of Wisconsin Hospital in Madison

Medical treatment: Vetens underwent a procedure known as penile inversion vaginoplasty to address her diagnosis of gender dysphoria, a condition resulting from one's sex identified at birth being in conflict with one's gender identity.

The procedure, in which the patient's penile and scrotal tissue is used to create a vagina, generally takes about two to four hours and requires a short inpatient stay, according to Dr. Madeline Deutsch, the medical director for transgender care at the University of California, San Francisco.

Candidates for the procedure must live for at least one year in their identified gender role and undergo at least one year of hormone therapy, Deutsch said. Preparation also includes permanent hair removal.

What gives: Though gender dysphoria is relatively uncommon, many of the billing and insurance issues Vetens encountered are typical for patients planning major surgery. Much of her stress and frustration arose from the vast difference between online price estimates ($19,000-$25,000), the hospital's billed price to the insurer ($91,850) and what it was willing to accept as an upfront cash payment ($20,080).

Hospitals set list prices high because insurers with whom they have contracts typically negotiate them down. In exchange for charging an insurer's members a lower price, doctors and hospitals gain access to those customers, who have incentives to use these in-network providers. Hospitals may offer package deals for procedures to patients, if they pay cash upfront, in part because the hospital avoids the hassle of negotiation.

Officials at University of Wisconsin Hospital said they offered Vetens the option to pay $20,080 for these reasons: to secure extra experience and exposure for the hospital's programs for transgender patients, and to shield Vetens from an even bigger bill. "We were trying to protect the patient," said Dr. Katherine Gast, Vetens' surgeon.

Dr. Kimberly Moreland (left) helped her daughter shop for an insurance plan that would cover Vetens' gender-confirmation surgery. Yet mother and daughter still found themselves caught between the hospital and the insurer. Courtesy of Richard Malatesta/Kimberly Moreland hide caption

Dr. Kimberly Moreland (left) helped her daughter shop for an insurance plan that would cover Vetens' gender-confirmation surgery. Yet mother and daughter still found themselves caught between the hospital and the insurer.

As both parties hedged their bets in trying to determine what a penile inversion vaginoplasty was worth, Vetens was stuck in the middle with the prospect of hugely varying payments.

Lisa Brunette, a hospital spokeswoman, said that, despite having provided Vetens an estimate of $100,000, the hospital really did not know how much it would charge for the procedure because it did not know how much it would be reimbursed by the insurance company. Vetens was the second person to have the procedure at the hospital.

The spokeswoman for the hospital said its contract with Vetens' insurer "relies on a complex formula."

And in an apparent chicken-and-egg quandary, Drew DiGiorgio, president and chief executive of Consolidated Health Plans, said the insurer did not know how much it would reimburse because it did not know how much the hospital would charge.

When Moreland called the hospital to pay the $20,080 price — an option she acknowledged many simply could not afford — she asked for an itemized bill.

The next day, she received a brief letter outlining some of the general services included for the price, such as "physician's fee" and "post surgery labs." Then it simply said: "Penile Inversion Vaginoplasty — $20,080.00."

"How in the world did you come up with a number if you have no idea what it covers?" she asked.

Had Vetens chosen a hospital that did not contract with her insurer, the family could have been reimbursed 60 percent, or about $12,000 of the money paid, since her insurance pays a portion of out-of-network care.

But since Consolidated Health Plans has a contract with the University of Wisconsin Hospital, it said it would not reimburse anything at all. Contracts between insurers and providers discourage such sideline cash transactions, since hospitals can make more money when patients use insurance, as evidenced by Vetens' bill.

Vetens and Moreland appealed to Consolidated Health Plans, feeling that they had been "the victims of a bait-and-switch scam."

The surprises didn't end there. Though multiple hospital representatives reassured Vetens that they wouldn't charge her insurance after her cash payment, Vetens received an explanation of benefits saying the hospital had billed her insurer nearly $92,000.

A hospital bill followed, identifying their $20,080 as "pre-payment," treating it like a partial deposit. Vetens owed more than $13,000, it said.

Studies have shown that more than half of hospital bills contain errors , a problem made worse by the fact that medical bills — with codes and jargon — can be nearly impossible for even savvy patients to understand.

"That was not supposed to happen. That was an error," said Abby Abongwa, a hospital billing official. "That was absolutely an error on our part."

Resolution: After the bill for $91,850 arrived, an alarmed Vetens showed it to her surgeon. The hospital quickly apologized and repaid her insurance company.

Within a few weeks of receiving the appeal — which noted that Vetens and Moreland had contacted a national media outlet — Consolidated Health Plans reimbursed Vetens nearly $18,000, offering her no explanation for why the company had ultimately decided to reverse its earlier judgement that it would not pay anything toward her care.

With their reimbursement, Vetens and Moreland paid about $2,100 for the surgery, all told.

The Takeaway: Be mindful that online pricing estimates frequently represent cash prices, which are often far lower than the price hospitals will bill your insurance.

Ask about a cash price — you may get a better deal. But if you forgo insurance, you're on your own. Your insurer is under no obligation to pay you back for any part of the bill or help you troubleshoot billing, and any payment you make likely will not count toward your deductible.

Enlist your doctor's help. Gast, Vetens' surgeon, proved a powerful advocate for her patient when disputes arose about billing and pricing. Billing representatives might not always be responsive to patients, but it's in the hospital executives' interest to keep staff surgeons happy.

Some of these issues can be settled only through legislation. Right now, there is no legal requirement for hospitals to provide itemized bills to patients. Hospital bills are fraught with errors, and there is little accountability for providers who bill erroneously.

In the meantime, don't be afraid to ask questions and fight back.

Bram Sable-Smith, who contributed to the audio story, is part of NPR's reporting partnership with Side Effects Public Media, member station KBIA and Kaiser Health News.

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.

You can follow Emmarie Huetteman on Twitter: @emmarieDC .

• transgender
• bill of the month
• gender dysphoria
• gender identity
• Health Insurance
• Plastic surgery

• Search Search Please fill out this field.

Does Insurance Cover Gender-Affirming Care?

Determining what your plan covers.

• Gender-Affirming Surgery Costs
• Gender-Affirming Medication Costs

Other Ways to Pay for Gender-Affirming Care and Surgery

Tips for financing gender-affirming care and surgery, the bottom line.

• Health Insurance
• Guide to Finance for LGBTQ+ People
• LGBTQ+ Marriage and Personal Finance
• The Costs of LGBTQ+ Family Planning
• Mortgage Lending for LGBTQ+ People
• Banks that Support the LGBTQ+ Community
• Overcoming LGBTQ+ Credit Barriers
• Top LGBTQ+ Financial Influencers
• Paying for College as an LGBTQ+ Student
• LGBTQ+ Representation in the Workforce
• LGBTQ+ Pay Gap and Unemployment
• Health Insurance for LGBTQ+ People
• How Being Nonbinary Affects Getting Life Insurance
• Qualifying for Life Insurance for Transgender People
• Paying for Transgender Surgeries CURRENT ARTICLE
• Investing in LGBTQ+ Friendly Investments
• Preparing for Retirement as an LGBTQ+ Person
• Social Security Benefit Equality for Same-Sex Couples
• LGBTQ+ Elder Care in Retirement

In many cases, health insurance in the U.S. covers gender-affirming care. However, whether or not your insurance plan will cover a specific gender-affirming treatment can depend on your state, your employer, and your plan's benefits.

Key Takeaways

• Health insurance generally covers gender-affirming care.
• Not all plans cover all procedures, however, and the process can be murky and require preauthorization.
• Gender-affirming care can cost tens of thousands of dollars without insurance coverage.

Major insurance companies today generally recognize transgender-related care as being medically necessary . However, at least 24 states have passed new laws or enacted new policies limiting coverage of gender-affirming care for people up to age 18. And some transgender people may still be denied coverage for certain procedures by their insurers.

1.6 million

The estimated number of Americans age 13 or older who identify as transgender, according to a 2022 study.

Health insurers generally cover an array of medically necessary services that affirm gender or treat gender dysphoria, according to the American Medical Association, which reaffirmed its advocacy for such care in 2023. Gender dysphoria is a condition that occurs when someone feels a conflict between the sex they were assigned at birth and the one they now identify with.

Gender-affirming care is the phrase used by most medical groups for dysphoria treatment. This care can include hormones, surgery, or counseling. The care aligns a person's gender identity with gender expression in appearance, anatomy, and voice.

In 2010, the federal Affordable Care Act (ACA) banned health insurance discrimination based on sexual orientation and gender identity. Before the law's passage, medically necessary gender-affirming surgeries and hormones often weren't covered by insurers.

A 2024 rule from the Department of Health and Human Services stated that covered entities (a term that includes both insurance plans and providers such as doctors) could not "deny or limit coverage, deny or limit coverage of a claim, or impose additional cost sharing or other limitations or restrictions on coverage, for specific health services related to gender transition or other gender-affirming care if such denial, limitation, or restriction results in discrimination on the basis of sex."

However, insurance is also regulated at the state level and rules can vary based on whether it is an ACA, public, or employer plan, so they don't apply evenly to all insurers.

Investopedia / Candra Huff

Policyholders and plan members can generally find out what's available to them in their member booklet. This should have been given to you when you got the policy or, if it's an employee plan, when you joined the company. It may be called a certificate of coverage, a benefit plan, a summary plan description, a certificate of insurance, or something similar.

This document should describe the insurer's clinical evidence criteria to qualify for claim coverage. For example, to begin hormone therapy, the requirements might include a diagnosis of gender dysphoria from a licensed mental health professional.

Some plans may list exclusions for certain procedures. Even if an exclusion exists in the documentation, it can still be worthwhile to apply for pre-authorization or pre-approval for the procedure to obtain an official decision. For one thing, as the Transgender Legal Defense & Education Fund, notes, "the plan booklet may simply be out of date."

Even if you're turned down, that is not necessarily the final word. If a preauthorization request or a claim is denied, an attorney, healthcare advocate, or your human resources department may be able to help with filing an appeal. Appeals should include individualized, extensive documentation of a service's medical necessity and appropriateness.

Here, we list four types of health insurance and how they might cover gender-affirming care.

Employer-Provided Insurance

Altogether, 24 states and the District of Columbia prohibit transgender exclusions in private health insurance coverage, according to the nonprofit LGBTQ+ advocacy organization Movement Advance Project, leaving half the states without such protections.

However, health coverage benefits that a private employer provides can vary based on whether the employer buys its coverage from an insurance company or is funding the plan itself. If the employer's plan is self-funded, it is governed by the federal law ERISA, the Employee Retirement Income Security Act , which overrides any state nondiscrimination law. The employer can decide what health care is or is not covered.

In the Human Rights Campaign's 2023-2024 Corporate Equality Index, a record 94% of the companies it evaluated offered at least one transgender-inclusive plan option.

Employer-based plans are governed in the state where the plan was issued, not where you live.

Affordable Care Act Plan Coverage

Individuals can buy their own health insurance policies, often with the help of federal subsidies, through the Healthcare.gov Marketplace. Most insurers have eliminated transgender-specific exclusions, which ACA regulations explicitly ban.

Still, policies vary by state and in what they cover. As the Healthcare.gov website notes, "Many health plans are still using exclusions such as 'services related to sex change' or 'sex reassignment surgery' to deny coverage to transgender people for certain health care services."

It suggests that before enrolling in a plan, consumers should carefully review its terms: "Plans might use different language to describe these kinds of exclusions. Look for language like 'All procedures related to being transgender are not covered.' Other terms to look for include 'gender change,' 'transsexualism,' 'gender identity disorder,' and 'gender identity dysphoria.'"

Fortunately, according to Out2Enroll, an organization connecting the LGBT+ community with healthcare coverage, when it recently reviewed silver Marketplace options in 32 states it found that "the vast majority of insurers did not use transgender-specific exclusions" and that "40% of plans had language indicating that all or some medically necessary gender-affirming care would be covered by the plan." (ACA coverage is broken down into bronze, silver, gold, and platinum plans, with silver being a moderately priced level.)

Out2Enroll also has state-specific Transgender Health Insurance Guides on its website for help in choosing a plan.

Medicare and Medicaid Coverage

About 6% of transgender adults receive their health coverage from Medicare, the federal insurance program primarily for Americans over age 65. Under these plans, medically necessary care—including some gender-affirming procedures—is covered. Private Medicare Advantage plans should abide by the same rules as traditional Medicare, but patients on such plans should try to get preauthorization before accessing transition-related services, the National Center for Transgender Equality advises.

Some 21% of transgender adults receive Medicaid, the joint federal and state health insurance plan for low-income Americans. On a state-by-state basis, Medicaid coverage is uneven. Medicaid programs explicitly cover transgender-related care in 26 states and the District of Columbia. Meanwhile, programs in 10 states bar coverage of transgender-related care for people of all ages, and programs in three states prohibit coverage of transgender-related care for minors.

Military and Veteran Coverage  

Active military members can access some types of gender-affirming care. TRICARE, the health benefits provider for military members, says it "covers hormone therapy and psychological counseling for gender dysphoria. TRICARE generally doesn't cover surgery for the treatment of gender dysphoria. However, active duty service members may request a waiver for medically necessary, gender affirming surgery."

The Veterans Health Administration offers gender-affirming healthcare, including hormones and prosthetics, mental health care, and other healthcare. Coverage for gender-affirming surgery has traditionally been denied but is currently undergoing a review.

How Much Does Gender-Affirming Surgery Cost?

The cost of gender-affirming care might range from $25,000 to $75,000, according to an estimate from the Human Rights Campaign.

Gender-affirming surgeries may include top surgery (breast removal or augmentation), bottom surgery, vocal surgery, and face and body surgeries such as browlifts, jawline contouring, Adam's apple removal, and forehead reduction.

Bottom surgery may include:

• Phalloplasty : Creation of penis 
• Metoidioplasty : Phallus created from existing genital region tissue. 
• Hysterectomy : Uterus and cervix removal  
• Nullification surgery : Creating a gender-neutral look in the groin
• Oophorectomy : Removal of one or both ovaries
• Vaginoplasty and vulvoplasty : Creation of vagina and vulva 
• Orchiectomy : Testicle removal 

Research published in 2022 by JAMA Surgery found that while gender-affirming surgery can be costly, insurance (for patients who have it) will often cover most of the cost. Looking at phalloplasty and vaginoplasty procedures specifically, it reported:

However, not all transgender people desire surgery. According to 2019 research statistics, only 28% of transgender women get any type of surgery, and only 4% to 13% receive genital surgery. Surgery is more common among transgender men, with 42% to 54% getting some type of surgery; up to 50% get genital surgery.

How Much Does Gender-Affirming Medication Cost?

Gender-affirming medication is far more common than surgery. As many as 65% of transgender people received gender-affirming hormone therapy in 2019, up from 17% in 2011, according to the Journal of Law, Medicine & Ethics .

The costs of gender-affirming medications can vary widely. While they are often at least partially covered by insurance, they also come with out-of-pocket costs, which may continue through the patient's lifetime.

For example, a study in the Journal of General Internal Medicine reported that, "in 2019, median prices for feminizing and masculinizing hormone therapy ranged from $6.76 to $91.15 and $31.82 to $398.99, respectively." At the same time, patients' "median out-of-pocket costs ranged from $5.00 to $10.71 and $10.00 to $12.86 for feminizing and masculinizing hormone therapy, respectively." Those prices refer to a 30-day supply.

Other costs can be involved as well. For example, patients who are taking hormones may need periodic blood tests to monitor their health.

A 2020 study in Annals of Family Medicine found that among insured respondents taking gender-affirming hormones, almost 21% reported that their claims were denied. This group (and those who are uninsured) were more likely to take nonprescription hormones from unlicensed sources, which may not be monitored for quality and potentially carry serious health risks.

Aside from health insurance, how can you pay for gender-affirming care or surgery? Here are some options.

Payment Plans 

Some healthcare providers offer payment plans directly or through lenders that let you pay off medical bills over time.

You might take out a personal loan or even a type of personal loan called a medical loan to cover expenses related to gender-affirming care or surgery. A medical loan is just a personal loan used to pay for medical expenses.

Credit Cards 

Credit cards cab be another avenue for covering the costs of gender-affirming care or surgery, although they tend to have very high interest rates if you run a balance.

Even with health insurance, hormone therapy may be less expensive if you comparison shop and use pharmacy programs, such as GoodRx.

Surgery Grants

Several organizations, such as the Jim Collins Foundation, offer grants for people seeking gender-affirming care or surgery.

Health Accounts 

If you have a flexible spending account (FSA) or health savings account (HSA) , consider allocating some account money for gendering-affirming care or surgery if you are anticipating it.

Health Reimbursement Agreement 

A health reimbursement agreement (HRA) is an employer-funded group health plan that reimburses employees for qualified medical expenses, which might include gender-affirming care or surgery.

Home Equity Loan or Line of Credit (HELOC) 

You could take out a home equity loan or line of credit to cover the costs of gender-affirming care or surgery. With these types of loans, you can typically borrow up to a certain percentage of your home's equity. Interest rates are generally lower than those on a personal loan, because your home serves as collateral. Just realize that if you can't repay the loan, your could lose your home. 

Friends and Family Loans 

If you've got supportive friends or relatives, they might be willing to chip in money to pay for your gender-affirming care or surgery. To avoid misunderstandings, it's usually best to have a written agreement and repayment plan.

Crowdfunding

You might consider setting up a crowdfunding campaign on a platform like GoFundMe to raise money from friends, relatives, colleagues, or even strangers.

When you're financing gender-affirming care or surgery, you may be able to save some money if you follow these tips.

Shop Around 

A number of online tools such as Hospital Cost Compare and Healthcare Bluebook allow you to compare costs for the same procedures and treatments offered by different healthcare providers. Doing this homework could save you a lot of money.

Check the Interest Rate Before You Borrow 

Be sure to investigate how much you'll pay to borrow money if you decide to go the credit card or loan route. 

Try Negotiating or Set up a Payment Plan

You can sometimes negotiate with a healthcare provider to lower the costs of gender-affirming care or surgery. For instance, a healthcare provider might discount your services if you agree to pay off your medical bills quickly. If a healthcare provider isn't willing to provide a discount, they might let you make interest-free payments as part of a payment plan.

Ask About Financial Assistance

Some nonprofit healthcare providers offer financial assistance programs that will cover all or some of your medical expenses.

What Are the Different Types of Gender-Affirming Care?

Various types of gender-affirming care include puberty-blocking medication, hormone therapy, top surgery, bottom surgery, nullification surgery, laser hair removal, facial feminization surgery, speech therapy, and mental health services.

How Much Does Gender-Affirming Care Cost in the U.S.?

The cost of gendering-affirming care varies widely, depending on the type of procedure or treatment involved. A common range is anywhere from $25,000 to $75,000, according to the Human Rights Campaign. Health insurance may cover these costs to varying degrees.

Does Insurance Cover Puberty Blockers?

According to one 2019 study, about 31% of the plans it looked at online claimed to cover puberty blockers. That makes it all the more important for patients and their families to shop around for insurance.

The campaign for transgender rights in the U.S. has experienced victories and setbacks in recent years—in some cases affecting coverage of gender-affirming care. Even amid progress, some people still encounter problems obtaining health insurance to cover such care or paying the out-of-pocket costs involved. People who expect to need gender-affirming care will want to read their insurance plan's coverage details carefully and ask questions if they're unsure about what's covered.

Human Rights Campaign. " Map: Attacks on Gender-Affirming Care by State ."

KFF. " Policy Tracker: Youth Access to Gender Affirming Care and State Policy Restrictions ."

The Williams Institute at UCLA. " How Many Adults and Youth Identify as Transgender in the United States? "

UCSF Transgender Care. " Initiating Hormone Therapy ."

American Medical Association. " Transgender Coverage Issue Brief ."

U.S. Department of Health and Human Services. " Section 1557 of the Patient Protection and Affordable Care Act ."

Transgender Legal Defense & Education Fund. " Health Insurance – Understanding Your Plan ."

Federal Register. " Vol. 89, No. 88 / Monday, May 6, 2024 / Rules and Regulations ," Page 37701.

Movement Advance Protect. " Healthcare Laws and Policies ."

Transgender Legal Defense & Education Fund. " Health Insurance – Understanding Your Plan: Differences Between Self-Funded and Insured Plans. "

Human Rights Campaign. " Corporate Equality Index 2023-2024 ."

HealthCare.gov. " Transgender Health Care ."  

Out2Enroll. " Plan Information for 2024 ."

Healthcare.gov. " How to Pick a Health Insurance Plan ."

KFF. " Trans People in the U.S.: Identities, Demographics, Wellbeing. "

Movement Advancement Project. " Medicaid Coverage of Transgender-Related Health Care ."

TRICARE. " Gender Dysphoria Services ."

U.S. Department of Veterans Affairs. "VHA LGBTQ+ Health Program. "

Annals of Family Medicine, November 2020. " Insurance Coverage and Use of Hormones Among Transgender Respondents to a National Survey ," See Abstract: Results.

Translational Andrology and Urology. " Demographic and Temporal Trends in Transgender Identities and Gender Confirming Surgery ."

JAMA Surgery. " Spending and Out-of-Pocket Costs for Genital Gender-Affirming Surgery in the U.S. "

The Journal of Law, Medicine, and Ethics. " Utilization and Costs of Gender-Affirming Care in a Commercially Insured Transgender Population ."

Journal of General Internal Medicine. " Gender Affirming Hormone Therapy Spending and Use in the USA, 2013-2019 ."

Transgender Health. April 11, 2019. " Health Care Insurance of Recommended Gender-Affirming Health Care Services for Transgender Youth: Shopping Online for Coverage Information ," See Table 1.

• Terms of Service
• Editorial Policy
• Privacy Policy

• Search Close Search submit

Female to Male Gender Reassignment Surgery (FTM GRS)

Female-to-male gender reassignment surgery (FTM GRS) is a complex and irreversible genital surgery for female transsexual who is diagnosed with gender identity disorder and has a strong desire to live as male. The procedure is to remove all female genital organs including the uterus, ovaries, and vagina with the construction of male genitalia composed of the penis and scrotum.  

The patient who is fit for this surgery must strictly follow the standard of care set by the World Professional Association of Transgender Healthcare (WPATH) or equivalent criteria; Express desire or live in another gender role (Female gender) long enough, under hormonal replacement therapy, evaluated and approved by a psychiatrist or other qualified professional gender therapist.  

Apart from genital surgery, the patient would seek other procedures to allow them to live as males smoothly such as breast amputation, facial surgery, body surgery, etc.  

Interested in having this procedure?

Useful Information

Ensure you consider all aspects of a procedure. You can speak to your surgeon about these areas of the surgery in more detail during a consultation.

The surgery is very complicated and only a handful of surgeons are able to perform this procedure. It is a multi-staged procedure, the first stage is the removal of the uterus, ovary, and vagina. The duration of the procedure is 2-3 hours. The second and later stages are penis and scrotum reconstruction which is at least 6 months later. There are several techniques for penile reconstruction depending on the type of tissue such as skin/fat of the forearm, skin/fat of the thigh, or adjacent tissue around the clitoris. This second stage of surgical time is between 3-5 hours. A penile prosthesis can be incorporated simultaneously or at a later stage. The scrotal prosthesis is also implanted later.  

The procedure is done under general anesthesia and might be combined with spinal anesthesia for faster recovery by reducing the usage of anesthetic gas.  

Inpatient/Outpatient

The patient will be hospitalized as an in-patient for between 5-7 days for each stage depending on the technique and surgeon. The patient will have a urinary catheter at all times in the hospital.  

Additional Information

What are the risks.

The most frequent complication of FTM GRS is bleeding, wound infection, skin flap or graft necrosis, urinary stenosis and fistula, unsightly scar, etc. The revision procedure is scar revision, hair transplant, or tattooing to camouflage unsightly scars.   

What is the recovery process?

During hospitalization, the patient must be restricted in bed continuously or intermittently for several days between 3-5 days. After release from the hospital, the patients return to their normal lives but not having to do physical exercise during the first 2 months after surgery. The patient will have a urinary catheter continuously for several weeks to avoid a urinary fistula. If the patient has a penile prosthesis, it would need at least 6 months before sexual intimacy.  

What are the results?

With good surgical technique, the result is very satisfying with an improved quality of life. The patient is able to live in a male role completely and happily either on their own or with their female or male partners.  

• Patient Information
• Global Statistics
• Media Centre
• Global Sponsors
• Privacy Policy

19 Mantua Road, Mount Royal, NJ 08061 United States

Registration number: 0330131

US Office: +1-603-643-2325

UK Office: +44 20 7038 7812

© 2022 International Society of Aesthetic Plastic Surgery. All Rights Reserved.

• Create an account

Log into My ISAPS

Forgot your password? Reset it here

Join the ISAPS Community

All members will continue to receive information relevant to their membership and ISAPS events.

I confirm by clicking below I would like to receive information about:

Welcome to the ISAPS community

By creating an account, you can:.

• Register for events
• Update your personal details
• Gain access to ISAPS publications and video library
• Become a member (explore our memberships here)

ISAPS Members can also:

• Access your member benefits
• Secure discounted member rates for events
• Read the Aesthetic Plastic Surgery Journal
• Gain full access to the video library
• View the Members Directory
• Update your 'Find a Surgeon' profile details
• Renew/Upgrade your Membership 

The first step to becoming a part of the community is creating an account, so join us!

Female to Male Surgery for Trans Men

As a transgender male, your goal for female to male surgery (FTM) for gender-confirmation can involve top surgery, bottom surgery, or both. You may or may not want facial procedures. It’s up to you.

Female to Male Surgery at UVA

We’re here to offer consultations, second opinions, and information to help you choose and plan. Come to us with your questions and concerns. We’ll explain:

• Procedure options and details
• Recovery and healing
• What to expect of your results

We want you to feel confident about the direction and quality of your care.

Charley's Gender-Confirmation Surgery

From a young age, Charley Burton knew that his body did not match his gender identity – a struggle he kept inside for 50 years. With the help of family nurse practitioner Reagan Thompson, FNP, MSN, RN, and a whole team of caring providers, Charley found a safe place to become his true self. View Charley's story transcript.

FTM Top Surgery

To give you a flatter chest, we’ll have to remove breast tissue. We might also need to move and shrink your areolas.

If you have smaller breasts, we can sometimes use liposuction, which doesn’t involve many incisions.

Larger breasts may require the “double incision” technique. This method saves the pectoralis major muscle, the most defining characteristic of a male chest.

Whatever your breast size, we will use the techniques that optimize the results.

FTM Bottom Surgery

We can give you male genitalia in two different ways:

• Phalloplasty creates a penis and urethra (to stand while urinating). We use tissue from your forearm or thigh. We do this in 2 stages.
• Metoidioplasty takes your existing genital tissue and makes it longer, turning it into a defined phallus. This needs only one surgery.

You may or may not want to also have an operation to remove your internal reproductive organs. A hysterectomy takes out your uterus, fallopian tubes, and ovaries.

Facial Masculinization

Through a combination of procedures, we can sculpt your chin, jaw, and cheeks to appear more masculine. We can also reshape your nose and make your Adam’s apple look bigger. We can use synthetic implants for this work.

Questions? See our  transgender surgery FAQs .

How Gender Reassignment Surgery Works (Infographic)

Bradley Manning, the U.S. Army private who was sentenced Aug. 21 to 35 years in a military prison for releasing highly sensitive U.S. military secrets, is seeking gender reassignment. Here’s how gender reassignment works:

Converting male anatomy to female anatomy requires removing the penis, reshaping genital tissue to appear more female and constructing a vagina.

An incision is made into the scrotum, and the flap of skin is pulled back. The testes are removed.

A shorter urethra is cut. The penis is removed, and the excess skin is used to create the labia and vagina.

People who have male-to-female gender-reassignment surgery retain a prostate. Following surgery, estrogen (a female hormone) will stimulate breast development, widen the hips, inhibit the growth of facial hair and slightly increase voice pitch.

Female-to-male surgery has achieved lesser success due to the difficulty of creating a functioning penis from the much smaller clitoral tissue available in the female genitals.

The uterus and the ovaries are removed. Genital reconstructive procedures (GRT) use either the clitoris, which is enlarged by hormones, or rely on free tissue grafts from the arm, the thigh or belly and an erectile prosthetic (phalloplasty).

Breasts need to be surgically altered if they are to look less feminine. This process involves removing breast tissue and excess skin, and reducing and properly positioning the nipples and areolae. Androgens (male hormones) will stimulate the development of facial and chest hair, and cause the voice to deepen.

Reliable statistics are extremely difficult to obtain. Many sexual-reassignment procedures are conducted in private facilities that are not subject to reporting requirements.

The cost for female-to-male reassignment can be more than $50,000. The cost for male-to-female reassignment can be $7,000 to $24,000.

Between 100 to 500 gender-reassignment procedures are conducted in the United States each year.

Sign up for the Live Science daily newsletter now

Get the world’s most fascinating discoveries delivered straight to your inbox.

Scientists made mice with Y chromosomes female by deleting just 6 tiny molecules

Man's years of premature ejaculation had a rare cause

Milky Way's black hole 'exhaust vent' discovered in eerie X-ray observations

Most Popular

• 2 China rover returns historic samples from far side of the moon — and they may contain secrets to Earth's deep past
• 3 Astronomers discover the 1st-ever merging galaxy cores at cosmic dawn
• 4 Earth's rotating inner core is starting to slow down — and it could alter the length of our days
• 5 2,000-year-old Roman military sandal with nails for traction found in Germany
• 2 2,000-year-old Roman military sandal with nails for traction found in Germany

• Introduction
• Conclusions
• Article Information

Error bars represent 95% CIs. GAS indicates gender-affirming surgery.

Percentages are based on the number of procedures divided by number of patients; thus, as some patients underwent multiple procedures the total may be greater than 100%. Error bars represent 95% CIs.

eTable.  ICD-10 and CPT Codes of Gender-Affirming Surgery

eFigure. Percentage of Patients With Codes for Gender Identity Disorder Who Underwent GAS

Data Sharing Statement

See More About

Sign up for emails based on your interests, select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing

Get the latest research based on your areas of interest.

Others also liked.

• Download PDF
• X Facebook More LinkedIn

Wright JD , Chen L , Suzuki Y , Matsuo K , Hershman DL. National Estimates of Gender-Affirming Surgery in the US. JAMA Netw Open. 2023;6(8):e2330348. doi:10.1001/jamanetworkopen.2023.30348

Manage citations:

© 2024

• Permissions

National Estimates of Gender-Affirming Surgery in the US

• 1 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York
• 2 Department of Obstetrics and Gynecology, University of Southern California, Los Angeles

Question   What are the temporal trends in gender-affirming surgery (GAS) in the US?

Findings   In this cohort study of 48 019 patients, GAS increased significantly, nearly tripling from 2016 to 2019. Breast and chest surgery was the most common class of procedures performed overall; genital reconstructive procedures were more common among older individuals.

Meaning   These findings suggest that there will be a greater need for clinicians knowledgeable in the care of transgender individuals with the requisite expertise to perform gender-affirming procedures.

Importance   While changes in federal and state laws mandating coverage of gender-affirming surgery (GAS) may have led to an increase in the number of annual cases, comprehensive data describing trends in both inpatient and outpatient procedures are limited.

Objective   To examine trends in inpatient and outpatient GAS procedures in the US and to explore the temporal trends in the types of GAS performed across age groups.

Design, Setting, and Participants   This cohort study includes data from 2016 to 2020 in the Nationwide Ambulatory Surgery Sample and the National Inpatient Sample. Patients with diagnosis codes for gender identity disorder, transsexualism, or a personal history of sex reassignment were identified, and the performance of GAS, including breast and chest procedures, genital reconstructive procedures, and other facial and cosmetic surgical procedures, were identified.

Main Outcome Measures   Weighted estimates of the annual number of inpatient and outpatient procedures performed and the distribution of each class of procedure overall and by age were analyzed.

Results   A total of 48 019 patients who underwent GAS were identified, including 25 099 (52.3%) who were aged 19 to 30 years. The most common procedures were breast and chest procedures, which occurred in 27 187 patients (56.6%), followed by genital reconstruction (16 872 [35.1%]) and other facial and cosmetic procedures (6669 [13.9%]). The absolute number of GAS procedures rose from 4552 in 2016 to a peak of 13 011 in 2019 and then declined slightly to 12 818 in 2020. Overall, 25 099 patients (52.3%) were aged 19 to 30 years, 10 476 (21.8%) were aged 31 to 40, and 3678 (7.7%) were aged12 to 18 years. When stratified by the type of procedure performed, breast and chest procedures made up a greater percentage of the surgical interventions in younger patients, while genital surgical procedures were greater in older patients.

Conclusions and Relevance   Performance of GAS has increased substantially in the US. Breast and chest surgery was the most common group of procedures performed. The number of genital surgical procedures performed increased with increasing age.

Gender dysphoria is characterized as an incongruence between an individual’s experienced or expressed gender and the gender that was assigned at birth. 1 Transgender individuals may pursue multiple treatments, including behavioral therapy, hormonal therapy, and gender-affirming surgery (GAS). 2 GAS encompasses a variety of procedures that align an individual patient’s gender identity with their physical appearance. 2 - 4

While numerous surgical interventions can be considered GAS, the procedures have been broadly classified as breast and chest surgical procedures, facial and cosmetic interventions, and genital reconstructive surgery. 2 , 4 Prior studies 2 - 7 have shown that GAS is associated with improved quality of life, high rates of satisfaction, and a reduction in gender dysphoria. Furthermore, some studies have reported that GAS is associated with decreased depression and anxiety. 8 Lastly, the procedures appear to be associated with acceptable morbidity and reasonable rates of perioperative complications. 2 , 4

Given the benefits of GAS, the performance of GAS in the US has increased over time. 9 The increase in GAS is likely due in part to federal and state laws requiring coverage of transition-related care, although actual insurance coverage of specific procedures is variable. 10 , 11 While prior work has shown that the use of inpatient GAS has increased, national estimates of inpatient and outpatient GAS are lacking. 9 This is important as many GAS procedures occur in ambulatory settings. We performed a population-based analysis to examine trends in GAS in the US and explored the temporal trends in the types of GAS performed across age groups.

To capture both inpatient and outpatient surgical procedures, we used data from the Nationwide Ambulatory Surgery Sample (NASS) and the National Inpatient Sample (NIS). NASS is an ambulatory surgery database and captures major ambulatory surgical procedures at nearly 2800 hospital-owned facilities from up to 35 states, approximating a 63% to 67% stratified sample of hospital-owned facilities. NIS comprehensively captures approximately 20% of inpatient hospital encounters from all community hospitals across 48 states participating in the Healthcare Cost and Utilization Project (HCUP), covering more than 97% of the US population. Both NIS and NASS contain weights that can be used to produce US population estimates. 12 , 13 Informed consent was waived because data sources contain deidentified data, and the study was deemed exempt by the Columbia University institutional review board. This cohort study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline.

We selected patients of all ages with an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision ( ICD-10 ) diagnosis codes for gender identity disorder or transsexualism ( ICD-10 F64) or a personal history of sex reassignment ( ICD-10 Z87.890) from 2016 to 2020 (eTable in Supplement 1 ). We first examined all hospital (NIS) and ambulatory surgical (NASS) encounters for patients with these codes and then analyzed encounters for GAS within this cohort. GAS was identified using ICD-10 procedure codes and Common Procedural Terminology codes and classified as breast and chest procedures, genital reconstructive procedures, and other facial and cosmetic surgical procedures. 2 , 4 Breast and chest surgical procedures encompassed breast reconstruction, mammoplasty and mastopexy, or nipple reconstruction. Genital reconstructive procedures included any surgical intervention of the male or female genital tract. Other facial and cosmetic procedures included cosmetic facial procedures and other cosmetic procedures including hair removal or transplantation, liposuction, and collagen injections (eTable in Supplement 1 ). Patients might have undergone procedures from multiple different surgical groups. We measured the total number of procedures and the distribution of procedures within each procedural group.

Within the data sets, sex was based on patient self-report. The sex of patients in NIS who underwent inpatient surgery was classified as either male, female, missing, or inconsistent. The inconsistent classification denoted patients who underwent a procedure that was not consistent with the sex recorded on their medical record. Similar to prior analyses, patients in NIS with a sex variable not compatible with the procedure performed were classified as having undergone genital reconstructive surgery (GAS not otherwise specified). 9

Clinical variables in the analysis included patient clinical and demographic factors and hospital characteristics. Demographic characteristics included age at the time of surgery (12 to 18 years, 19 to 30 years, 31 to 40 years, 41 to 50 years, 51 to 60 years, 61 to 70 years, and older than 70 years), year of the procedure (2016-2020), and primary insurance coverage (private, Medicare, Medicaid, self-pay, and other). Race and ethnicity were only reported in NIS and were classified as White, Black, Hispanic and other. Race and ethnicity were considered in this study because prior studies have shown an association between race and GAS. The income status captured national quartiles of median household income based of a patient’s zip code and was recorded as less than 25% (low), 26% to 50% (medium-low), 51% to 75% (medium-high), and 76% or more (high). The Elixhauser Comorbidity Index was estimated for each patient based on the codes for common medical comorbidities and weighted for a final score. 14 Patients were classified as 0, 1, 2, or 3 or more. We separately reported coding for HIV and AIDS; substance abuse, including alcohol and drug abuse; and recorded mental health diagnoses, including depression and psychoses. Hospital characteristics included a composite of teaching status and location (rural, urban teaching, and urban nonteaching) and hospital region (Northeast, Midwest, South, and West). Hospital bed sizes were classified as small, medium, and large. The cutoffs were less than 100 (small), 100 to 299 (medium), and 300 or more (large) short-term acute care beds of the facilities from NASS and were varied based on region, urban-rural designation, and teaching status of the hospital from NIS. 8 Patients with missing data were classified as the unknown group and were included in the analysis.

National estimates of the number of GAS procedures among all hospital encounters for patients with gender identity disorder were derived using discharge or encounter weight provided by the databases. 15 The clinical and demographic characteristics of the patients undergoing GAS were reported descriptively. The number of encounters for gender identity disorder, the percentage of GAS procedures among those encounters, and the absolute number of each procedure performed over time were estimated. The difference by age group was examined and tested using Rao-Scott χ 2 test. All hypothesis tests were 2-sided, and P  < .05 was considered statistically significant. All analyses were conducted using SAS version 9.4 (SAS Institute Inc).

A total of 48 019 patients who underwent GAS were identified ( Table 1 ). Overall, 25 099 patients (52.3%) were aged 19 to 30 years, 10 476 (21.8%) were aged 31 to 40, and 3678 (7.7%) were aged 12 to 18 years. Private insurance coverage was most common in 29 064 patients (60.5%), while 12 127 (25.3%) were Medicaid recipients. Depression was reported in 7192 patients (15.0%). Most patients (42 467 [88.4%]) were treated at urban, teaching hospitals, and there was a disproportionate number of patients in the West (22 037 [45.9%]) and Northeast (12 396 [25.8%]). Within the cohort, 31 668 patients (65.9%) underwent 1 procedure while 13 415 (27.9%) underwent 2 procedures, and the remainder underwent multiple procedures concurrently ( Table 1 ).

The overall number of health system encounters for gender identity disorder rose from 13 855 in 2016 to 38 470 in 2020. Among encounters with a billing code for gender identity disorder, there was a consistent rise in the percentage that were for GAS from 4552 (32.9%) in 2016 to 13 011 (37.1%) in 2019, followed by a decline to 12 818 (33.3%) in 2020 ( Figure 1 and eFigure in Supplement 1 ). Among patients undergoing ambulatory surgical procedures, 37 394 (80.3%) of the surgical procedures included gender-affirming surgical procedures. For those with hospital admissions with gender identity disorder, 10 625 (11.8%) of admissions were for GAS.

Breast and chest procedures were most common and were performed for 27 187 patients (56.6%). Genital reconstruction was performed for 16 872 patients (35.1%), and other facial and cosmetic procedures for 6669 patients (13.9%) ( Table 2 ). The most common individual procedure was breast reconstruction in 21 244 (44.2%), while the most common genital reconstructive procedure was hysterectomy (4489 [9.3%]), followed by orchiectomy (3425 [7.1%]), and vaginoplasty (3381 [7.0%]). Among patients who underwent other facial and cosmetic procedures, liposuction (2945 [6.1%]) was most common, followed by rhinoplasty (2446 [5.1%]) and facial feminizing surgery and chin augmentation (1874 [3.9%]).

The absolute number of GAS procedures rose from 4552 in 2016 to a peak of 13 011 in 2019 and then declined slightly to 12 818 in 2020 ( Figure 1 ). Similar trends were noted for breast and chest surgical procedures as well as genital surgery, while the rate of other facial and cosmetic procedures increased consistently from 2016 to 2020. The distribution of the individual procedures performed in each class were largely similar across the years of analysis ( Table 3 ).

When stratified by age, patients 19 to 30 years had the greatest number of procedures, 25 099 ( Figure 2 ). There were 10 476 procedures performed in those aged 31 to 40 years and 4359 in those aged 41 to 50 years. Among patients younger than 19 years, 3678 GAS procedures were performed. GAS was less common in those cohorts older than 50 years. Overall, the greatest number of breast and chest surgical procedures, genital surgical procedures, and facial and other cosmetic surgical procedures were performed in patients aged 19 to 30 years.

When stratified by the type of procedure performed, breast and chest procedures made up the greatest percentage of the surgical interventions in younger patients while genital surgical procedures were greater in older patients ( Figure 2 ). Additionally, 3215 patients (87.4%) aged 12 to 18 years underwent GAS and had breast or chest procedures. This decreased to 16 067 patients (64.0%) in those aged 19 to 30 years, 4918 (46.9%) in those aged 31 to 40 years, and 1650 (37.9%) in patients aged 41 to 50 years ( P  < .001). In contrast, 405 patients (11.0%) aged 12 to 18 years underwent genital surgery. The percentage of patients who underwent genital surgery rose sequentially to 4423 (42.2%) in those aged 31 to 40 years, 1546 (52.3%) in those aged 51 to 60 years, and 742 (58.4%) in those aged 61 to 70 years ( P  < .001). The percentage of patients who underwent facial and other cosmetic surgical procedures rose with age from 9.5% in those aged 12 to 18 years to 20.6% in those aged 51 to 60 years, then gradually declined ( P  < .001). Figure 2 displays the absolute number of procedure classes performed by year stratified by age. The greatest magnitude of the decline in 2020 was in younger patients and for breast and chest procedures.

These findings suggest that the number of GAS procedures performed in the US has increased dramatically, nearly tripling from 2016 to 2019. Breast and chest surgery is the most common class of procedure performed while patients are most likely to undergo surgery between the ages of 19 and 30 years. The number of genital surgical procedures performed increased with increasing age.

Consistent with prior studies, we identified a remarkable increase in the number of GAS procedures performed over time. 9 , 16 A prior study examining national estimates of inpatient GAS procedures noted that the absolute number of procedures performed nearly doubled between 2000 to 2005 and from 2006 to 2011. In our analysis, the number of GAS procedures nearly tripled from 2016 to 2020. 9 , 17 Not unexpectedly, a large number of the procedures we captured were performed in the ambulatory setting, highlighting the need to capture both inpatient and outpatient procedures when analyzing data on trends. Like many prior studies, we noted a decrease in the number of procedures performed in 2020, likely reflective of the COVID-19 pandemic. 18 However, the decline in the number of procedures performed between 2019 and 2020 was relatively modest, particularly as these procedures are largely elective.

Analysis of procedure-specific trends by age revealed a number of important findings. First, GAS procedures were most common in patients aged 19 to 30 years. This is in line with prior work that demonstrated that most patients first experience gender dysphoria at a young age, with approximately three-quarters of patients reporting gender dysphoria by age 7 years. These patients subsequently lived for a mean of 23 years for transgender men and 27 years for transgender women before beginning gender transition treatments. 19 Our findings were also notable that GAS procedures were relatively uncommon in patients aged 18 years or younger. In our cohort, fewer than 1200 patients in this age group underwent GAS, even in the highest volume years. GAS in adolescents has been the focus of intense debate and led to legislative initiatives to limit access to these procedures in adolescents in several states. 20 , 21

Second, there was a marked difference in the distribution of procedures in the different age groups. Breast and chest procedures were more common in younger patients, while genital surgery was more frequent in older individuals. In our cohort of individuals aged 19 to 30 years, breast and chest procedures were twice as common as genital procedures. Genital surgery gradually increased with advancing age, and these procedures became the most common in patients older than 40 years. A prior study of patients with commercial insurance who underwent GAS noted that the mean age for mastectomy was 28 years, significantly lower than for hysterectomy at age 31 years, vaginoplasty at age 40 years, and orchiectomy at age 37 years. 16 These trends likely reflect the increased complexity of genital surgery compared with breast and chest surgery as well as the definitive nature of removal of the reproductive organs.

This study has limitations. First, there may be under-capture of both transgender individuals and GAS procedures. In both data sets analyzed, gender is based on self-report. NIS specifically makes notation of procedures that are considered inconsistent with a patient’s reported gender (eg, a male patient who underwent oophorectomy). Similar to prior work, we assumed that patients with a code for gender identity disorder or transsexualism along with a surgical procedure classified as inconsistent underwent GAS. 9 Second, we captured procedures commonly reported as GAS procedures; however, it is possible that some of these procedures were performed for other underlying indications or diseases rather than solely for gender affirmation. Third, our trends showed a significant increase in procedures through 2019, with a decline in 2020. The decline in services in 2020 is likely related to COVID-19 service alterations. Additionally, while we comprehensively captured inpatient and ambulatory surgical procedures in large, nationwide data sets, undoubtedly, a small number of procedures were performed in other settings; thus, our estimates may underrepresent the actual number of procedures performed each year in the US.

These data have important implications in providing an understanding of the use of services that can help inform care for transgender populations. The rapid rise in the performance of GAS suggests that there will be a greater need for clinicians knowledgeable in the care of transgender individuals and with the requisite expertise to perform GAS procedures. However, numerous reports have described the political considerations and challenges in the delivery of transgender care. 22 Despite many medical societies recognizing the necessity of gender-affirming care, several states have enacted legislation or policies that restrict gender-affirming care and services, particularly in adolescence. 20 , 21 These regulations are barriers for patients who seek gender-affirming care and provide legal and ethical challenges for clinicians. As the use of GAS increases, delivering equitable gender-affirming care in this complex landscape will remain a public health challenge.

Accepted for Publication: July 15, 2023.

Published: August 23, 2023. doi:10.1001/jamanetworkopen.2023.30348

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2023 Wright JD et al. JAMA Network Open .

Corresponding Author: Jason D. Wright, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave, 4th Floor, New York, NY 10032 ( [email protected] ).

Author Contributions: Dr Wright had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Wright, Chen.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Wright.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Wright, Chen.

Administrative, technical, or material support: Wright, Suzuki.

Conflict of Interest Disclosures: Dr Wright reported receiving grants from Merck and personal fees from UpToDate outside the submitted work. No other disclosures were reported.

Data Sharing Statement: See Supplement 2 .

• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts

Jump to content

Updated visitor policies

Other michigan medicine sites.

• About Michigan Medicine
• UofMHealth.org
• Medical School
• Find a Clinical Trial

Michigan Medicine

Federated search page form block, quick links.

• Patient Portal Login
• For Health Providers
• Maps & Directions

Gender Confirmation Surgery

The University of Michigan Health System offers procedures for surgical gender transition.  Working together, the surgical team of the Comprehensive Gender Services Program, which includes specialists in plastic surgery, urology and gynecology, bring expertise, experience and safety to procedures for our transgender patients.

Access to gender-related surgical procedures for patients is made through the University of Michigan Health System Comprehensive Gender Services Program .

The Comprehensive Gender Services Program adheres to the WPATH Standards of Care , including the requirement for a second-opinion prior to genital sex reassignment.

Available surgeries:

Male-to-Female:  Tracheal Shave  Breast Augmentation  Facial Feminization  Male-to-Female genital sex reassignment

Female-to-Male:  Hysterectomy, oophorectomy, vaginectomy Chest Reconstruction  Female-to-male genital sex reassignment

Sex Reassignment Surgeries (SRS)

At the University of Michigan Health System, we are dedicated to offering the safest proven surgical options for sex reassignment (SRS.)   Because sex reassignment surgery is just one step for transitioning people, the Comprehensive Gender Services Program has access to providers for mental health services, hormone therapy, pelvic floor physiotherapy, and speech therapy.  Surgical procedures are done by a team that includes, as appropriate, gynecologists, urologists, pelvic pain specialists and a reconstructive plastic surgeon. A multi-disciplinary team helps to best protect the health of the patient.

For patients receiving mental health and medical services within the University of Michigan Health System, the UMHS-CGSP will coordinate all care including surgical referrals.  For patients who have prepared for surgery elsewhere, the UMHS-CGSP will help organize the needed records, meet WPATH standards, and coordinate surgical referrals.  Surgical referrals are made through Sara Wiener the Comprehensive Gender Services Program Director.

Male-to-female sex reassignment surgery

At the University of Michigan, participants of the Comprehensive Gender Services Program who are ready for a male-to-female sex reassignment surgery will be offered a penile inversion vaginoplasty with a neurovascular neoclitoris.

During this procedure, a surgeon makes “like become like,” using parts of the original penis to create a sensate neo-vagina. The testicles are removed, a procedure called orchiectomy. The skin from the scrotum is used to make the labia. The erectile tissue of the penis is used to make the neoclitoris. The urethra is preserved and functional.

This procedure provides for aesthetic and functional female genitalia in one 4-5 hour operation.  The details of the procedure, the course of recovery, the expected outcomes, and the possible complications will be covered in detail during your surgical consultation. What to Expect: Vaginoplasty at Michigan Medicine .

Female-to-male sex reassignment

At the University of Michigan, participants of the Comprehensive Gender Services Program who are ready for a female-to-male sex reassignment surgery will be offered a phalloplasty, generally using the radial forearm flap method. 

This procedure, which can be done at the same time as a hysterectomy/vaginectomy, creates an aesthetically appropriate phallus and creates a urethera for standing urination.  Construction of a scrotum with testicular implants is done as a second stage.  The details of the procedure, the course of recovery, the expected outcomes, and the possible complications will be covered in detail during your surgical consultation.

Individuals who desire surgical procedures who have not been part of the Comprehensive Gender Services Program should contact the program office at (734) 998-2150 or email [email protected] . W e will assist you in obtaining what you need to qualify for surgery.

• Biochemistry and Molecular Biology
• Biostatistics
• Environmental Health and Engineering
• Epidemiology
• Health Policy and Management
• Health, Behavior and Society
• International Health
• Mental Health
• Molecular Microbiology and Immunology
• Population, Family and Reproductive Health
• Program Finder
• Admissions Services
• Course Directory
• Academic Calendar
• Hybrid Campus
• Lecture Series
• Convocation
• Strategy and Development
• Implementation and Impact
• Integrity and Oversight
• In the School
• In the Field
• In Baltimore
• Resources for Practitioners
• Articles & News Releases
• In The News
• Statements & Announcements
• At a Glance
• Student Life
• Strategic Priorities
• Inclusion, Diversity, Anti-Racism, and Equity (IDARE)
• What is Public Health?

Study: Paying for Transgender Health Care Cost-Effective

Most health insurance plans do not cover care associated with transitioning to the opposite sex.

A new analysis led by the Johns Hopkins Bloomberg School of Public Health suggests that while most U.S. health insurance plans deny benefits to transgender men and women for medical care necessary to transition to the opposite sex, paying for sex reassignment surgery and hormones is actually cost-effective.

The researchers, reporting online in the Journal of General Internal Medicine , say that the cost of surgery and hormones is not significantly higher than the cost of treatment for depression, substance abuse and HIV/AIDS, all of which are highly prevalent in those who are transgender but are not in a position to medically transition to the opposite sex. In 2014, the Center for Medicare and Medicaid Services began paying for sex reassignment surgery and other transitional care, after a 33-year-ban on covering those costs was lifted.

“Providing health care benefits to transgender people makes economic sense,” says study leader William V. Padula, PhD, MS, MSc, an assistant professor of health policy and management at the Bloomberg School. “Many insurance companies have said that it’s not worth it to pay for these services for transgender people. Our study shows they don’t have an economic leg to stand on when they decide to deny coverage. This is a small population of people and we can do them a great service without a huge financial impact on society.”

Estimates vary widely but it is believed that between 3,000 and 9,000 Americans undergo sex reassignment surgery each year. Transition medical care can include hormone replacement therapy, mastectomy, plastic surgery, psychotherapy and more.

For their study, Padula and colleagues analyzed data from the 2011 National Transgender Discrimination Survey, which includes information on access to medical care and health outcomes, as well as the Healthcare Bluebook, which outlines the cost of medical services. They also looked at previously published research on the topic.

When determining cost-effectiveness of medical services in the U.S., policymakers consider something cost-effective if the price is below $100,000 per year of quality of life. In the first five years, the researchers found, providing health care for transgender people cost between $34,000 and $43,000 per year of quality of life; after 10 years, the cost dropped to between $7,000 and $10,000 per year of quality of life.

Padula likens the case of paying for transgender care to caring for people with rare diseases. For example, cystic fibrosis affects just 30,000 people in the United States but can be treated as a chronic condition with the availability of new medications at a cost of $300,000 per year. While this is neither cost-effective nor individually affordable, Padula says, society has decided to pay for the treatment out of compassion. The same can be done for transgender people, he says.

Health insurance policies also pay for treatments that can be considered elective, such as breast reduction and spinal fusion as well as medication for erectile dysfunction. Some employers and health insurance companies do offer at least one plan that covers transition care, but that is not the norm, Padula says.

“Most U.S. health insurance policies still contain transgender exclusions, even though treatment of gender identity disorder is neither cosmetic nor experimental,” he says.

The new analysis calculated that the cost to cover transgender people would be fewer than two pennies per month for every person with health insurance coverage in the United States.

“We would be paying a very small incremental amount to improve the quality of life for a population that is extremely disenfranchised from health care and other services we consider a right,” Padula says. “For this small investment for a small number of people, we could improve their lives significantly and make them more productive members of society.”

He says that providing sex-reassignment surgery and other services to transgender people could help mitigate the expenses of treating depression, which often occurs in people who cannot transition, often because they do not have the financial means, as well as drug abuse and HIV/AIDS.

“ Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis ” was written by William V. Padula, Shiona Heru and Jonathan D. Campbell. Heru worked with the Commonwealth of Massachusetts Group Insurance Commission and Campbell is with the University of Colorado.

Funding for this study includes an F32 National Research Service Award from the Agency for Healthcare Research and Quality, a University of Chicago Medicine Small Grant in Diversity Research and a merit fellowship from Western New England University School of Law in affiliation with the Gender and Sexuality Center.

Media contacts for the Johns Hopkins Bloomberg School of Public Health: Stephanie Desmon at 410-955-7619 or  [email protected]   and Susan Murrow at 410-955-7624 and  [email protected] .

I Can't Afford to Transition: The Unseen Costs of Being Transgender

Living authentically comes with a hefty price tag.

Trans(form) is a month-long series on MarieClaire.com that explores the challenges, surprises, and victories of transitioning today. See the full collection  here .

Ari Klamka, 28, is a lot like his peers—when he found himself in need of money for a special project, he created  a GoFundMe page . But he wasn't looking to make a movie, or support a charity, or run a marathon. He was looking for the right to become himself.

Klamka is transgender, and he's facing an unfortunately common problem in the modern landscape of transgender issues: The cost of fully transitioning is prohibitively expensive.

"I've legally changed my name and gone through countless physical and social changes over the past two years," Klamka  writes on his GoFundMe page . "Though the next step I will be taking is the biggest and most important to me." It's not just a chest reconstructive surgery he has to pay for, but the doctors' visits, pain medications, continued hormones, and lost wages from taking time off to recover. His job as a veterinary assistant offers insurance, but it won't cover his needs.

Some phalloplasties can cost upwards of $100,000.

"I was born in the wrong body" is a common phrase used by transgender individuals to explain their desire for transition. And while not all those who identify as transgender want to physically alter their bodies or appearance, many see those changes as essential to becoming who they are and who they want to be. In too many cases, it can even be  life and death .

When Caitlyn Jenner revealed her true self to the world, she did so after undergoing  facial feminization surgery  and breast augmentation. Transitioning isn't just an enormous mental and emotional step—it's an expensive one, too.

Hormones might set you back $100 a month. Surgery? Anywhere from $5,000 to $50,000—and even higher. Some phalloplasties can cost upwards of $100,000, according to the  Transgender Law Center .

Stay In The Know

Marie Claire email subscribers get intel on fashion and beauty trends, hot-off-the-press celebrity news, and more. Sign up here.

The financial barriers are abundant, but they are born of two central issues: insurance and discrimination. "For transgender individuals to have access to insurance coverage continues to be a real problem," says Anand Kalra, the Transgender Law Center's health programs manager. Kalra explains that the transgender community—due in large part to being discriminated against—face higher rates of poverty. Translation? They're less likely to be insured. "Just having access to regular medical care can be an extreme challenge," he says.

Dr. Douglas Senderoff, a  New York-based plastic surgeon  who often works with transgender patients, agrees. "Most of the patients I consult with for transgender surgery are in difficult financial situations due to discrimination," he says. "It's often difficult for them to find quality, high-paying jobs."

Navigating the pitfalls of insurance language and coverage is frustrating for anyone. When you're trans, it's that much harder.

Even for those who are insured, there are still endless hoops to jump through. Not only is it difficult to find physicians who are trained and respectful of trans issues—Kalra recounts stories of people making same-day appointments with trans-friendly doctors, then carpooling for hours to get there—but navigating the pitfalls of insurance language and coverage is frustrating for  anyone . When you're trans, it's that much harder.

Some insurance agencies are making moves to update their policies. In fact, Aetna—one of the biggest health carriers in the U.S.—became the first major health-benefits company to cover gender-reassignment surgery for its holders in 2009. While others are following suit, there's still a divide between what's needed and what patients can get.

"Many providers have exclusions, deep in the plan documents, where they won't pay for things not only related to your transition, but  because  of your transition," Kalra says. "I've seen circumstances where a person broke their leg and had a cast put on, only to be told by the insurance agency that they're not going to pay for that because the person was on hormones. The insurance company was claiming that hormones had weakened the person's bones, even though clinical research has shown that's not true."

While many insurers are willing to work with individuals, there are far too many horror stories for them to be considered isolated incidents. "It can be exhausting and intimidating, and so confusing," Kalra says.

Worse, it can be life-threatening. In the face of desperation, it can seem to some like the only option is an unlicensed back-alley practitioner—resulting in  botched surgeries and potentially fatal injections .

Thankfully, there's recourse. Ten states plus D.C. have issued non-discrimination stipulations specifically related to health insurance. You can go through an appeals process in many states if your insurance says it won't cover specific items. "Sometimes, even when your insurance should say yes to something, they say no, because that's what they're used to when it comes to transgender needs," says Kalra. "For years, there weren't many rules. Now, they can still say no—but you can do something about it."

Dr. Harrison Lee, the surgeon who  performed Caitlyn Jenner's facial feminization procedures , does see the insurance landscape changing. "It's important to understand that for insurance to pay for any transgender surgery, the surgery needs to be considered 'medically necessary,'" he explains. Thanks to Jenner and other television shows depicting transgender characters, "Americans are becoming more aware of the plight of the transgender community. Health-insurance companies realize the need to cover transgender surgery as a medically necessary procedure as opposed to a cosmetic one. I  have  noticed that insurance companies are more cooperative when seeking approval for coverage."

For now, the solutions are those standard-bearers of American healthcare: patience and perseverance. And there's creativity.

Nina Iraheta, 23, is a trans woman working as a receptionist at an optical company. She emigrated to the U.S. from Brazil at the age of 13. "I already knew by that age that I was in the wrong body," she says. She experimented in high school with eyeliner and growing out her hair. "The littlest changes were making a difference, emotionally," she says. "I was happier."

She learned about hormone treatments in college, and after graduation, she found herself with the typical 20-something conundrum: no savings, crazy rent, and major student loans. Those needs, along with the cost of hormones and a desire for breast implants, led her to join  SeekingArrangement.com .

The site helps introduce "sugar babies" to "sugar daddies"—it's a place, according to its tagline, "where beautiful, successful people fuel mutually beneficial relationships." The average sugar baby receives $3,000 a month from a relationship, and out of the 3.8 million sugar babies on the network, there are over 15,000 transgender individuals. Iraheta makes sure her suitors know that she is transgender, and she now has one sugar daddy she sees on a weekly basis.

"It's been good," she says of her three-month experience. "You have to have a connection with the person; it doesn't work if you don't. I put all the money he gives me towards surgery."

Iraheta wants to go through "the whole process," and is currently undergoing laser hair removal treatments while continuing her hormone therapy. She's hoping to start her full transition by the age of 24.

Both Klamka with his GoFundMe page and Iraheta with her sugar daddy describe their situations as "frustrating," but they're committed to making it work.

"Sometimes I ask myself, 'Is this worth it? Is it worth going through all this? Do I  need  these surgeries?'" Iraheta says. "But then I realize that yes, I do. I would be happier. I already am happier."

This story is a part of  Marie Claire 's features series on what it means to transition today. Check back throughout the summer to read more, or find collected articles  here .

Samantha Leal is the Deputy Editor at Well+Good, where she spends most of her day thinking of new ideas across platforms, bringing on new writers, overseeing the day-to-day of the website, and working with the awesome team to produce the best stories and packages. Before W+G, she was the Senior Web Editor for Marie Claire and the Deputy Editor for Latina.com, with bylines all over the internet. Graduating from the Medill School of Journalism at Northwestern University with a minor in African history, she’s written everything from travel guides to political op-eds to wine explainers (currently enrolled in the WSET program) to celebrity profiles. Find her online pretty much everywhere @samanthajoleal.

The actress said the discourse tends to come for women more than men.

By Iris Goldsztajn Published 27 June 24

She paired the controversial shoe with the easiest summer outfit.

By Halie LeSavage Last updated 27 June 24

“I think we have to hope that this is nothing too serious for Princess Anne.”

By Rachel Burchfield Published 26 June 24

"Racism is a visceral experience...It dislodges brains, blocks airways, rips muscle, extracts organs, cracks bones, breaks teeth. You must never look away from this."

By Katherine J. Igoe Published 29 April 21

It’s high time to start representing the different types of mother-daughter relationships—or lack thereof—that exist during the holiday.

By Christina Wyman Published 27 April 21

Read an excerpt from Michelle Zauner's memoir, here, then dive in with us throughout the month.

By Rachel Epstein Published 25 April 21

The definition of page-turners.

By Maria Ricapito Last updated 29 November 23

These are life stories worth knowing.

By Bianca Rodriguez Last updated 2 February 23

The Christian church’s norms provide the perfect cover for sexual predators—and leave their victims feeling like the sinners.

By Leslie Goldman Published 28 October 20

How my stepfather's past changed my future.

By Sine Nomine Published 18 September 19

Even in our hyperconnected world, true friendship remain elusive for young women looking to rebuild their college-era squads.

By Maggie Bullock Published 10 December 18

• Contact Future's experts
• Advertise Online
• Terms and conditions
• Privacy policy
• Cookies policy

Marie Claire is part of Future plc, an international media group and leading digital publisher. Visit our corporate site . © Future US, Inc. Full 7th Floor, 130 West 42nd Street, New York, NY 10036.

Gender Reassignment Surgery Market size is set to grow by USD 369 million from 2024-2028, Increase in number of people opting for sex change surgeries globally boost the market, Technavio

News provided by

Jun 28, 2024, 17:35 ET

Share this article

NEW YORK , June 28, 2024 /PRNewswire/ -- The global gender reassignment surgery market size is estimated to grow by USD 369 million from 2024-2028, according to Technavio. The market is estimated to grow at a CAGR of over 11.92%  during the forecast period. Increase in number of people opting for sex change surgeries globally is driving market growth, with a trend towards advancements in medical technology. However, high cost of surgeries  poses a challenge. Key market players include Andrew Ives ., Boston Childrens Hospital, Boston Medical Center, Chettawut Plastic Surgery Center, CNY Cosmetic and Reconstructive Surgery, Crane Center, Icahn School of Medicine at Mount Sinai , IVAN MANERO CLINIC S.L., Moein Surgical Arts, Oregon Health and Science University, Phuket International Aesthetic Centre PIAC, Plastic Surgery Group of Rochester , Regents of the University of Michigan , Rumer Cosmetic Surgery, Sava Perovic Foundation Surgery, The Johns Hopkins Health System Corp., Transgender Surgery Institute, and University of Pennsylvania Health System.

Get a detailed analysis on regions, market segments, customer landscape, and companies-  View the snapshot of this report

Market Driver

The global gender reassignment surgery market is experiencing significant growth due to advancements in medical technology. Innovations include minimally invasive surgical techniques, improved medical devices, imaging technologies, and perioperative care practices. These advancements offer benefits such as smaller incisions, faster recovery times, and enhanced patient experiences. Tissue engineering and regenerative medicine also hold promise for enhancing surgery outcomes. Anesthesia and pain management advancements optimize patient comfort and reduce complications, contributing to market growth. Healthcare providers leverage these technologies to meet the increasing demand for gender-affirming treatments and improve transgender individuals' quality of life. 

The gender reassignment surgery market is experiencing significant growth due to increasing acceptance and awareness of transgender rights. Quite a number of people undergo this procedure to align their physical appearance with their gender identity. The services involved include hormone therapy, surgeries such as chest reconstruction and genital reassignment, and other related procedures. The cost of these procedures can be substantial, but many countries offer coverage under their healthcare systems. The industry is also seeing advancements in technology and techniques, making the procedures safer and more effective. Additionally, the availability of financing options and support groups is helping more individuals access these services. Overall, the gender reassignment surgery market is poised for continued expansion in the coming years. 

Research report provides comprehensive data on impact of trend. For more details-  Download a Sample Report

Market Challenges

• The gender reassignment surgery market involves significant expenses, including hormone therapy, counseling, and living as a target gender in the year preceding the procedure. The cost of the surgery itself ranges from USD0.2 - USD0.8 million , depending on the transition type. Ongoing costs, such as hormone therapy and doctor visits, add to the overall expense. A year of therapy with a psychologist, required before physical transition, costs USD1,000 - USD1,500 per session, totaling USD48,000 - USD72,000 . These high costs may hinder market growth during the forecast period.
• The Gender Reassignment Surgery market faces several challenges. Healthcare providers offer various procedures such as hormone therapy, surgeries, and counseling services. However, access to these services can be a concern for many individuals. Costs for gender reassignment surgeries can be high, making it difficult for some to afford. Additionally, there are regulatory and legal challenges that can impact the availability and affordability of these services. Furthermore, cultural and societal norms can create stigma and discrimination, making it challenging for individuals to seek out the care they need. Despite these challenges, the market continues to grow as more individuals seek gender affirming care. Companies must address these challenges to provide accessible and affordable options for those in need.

For more insights on driver and challenges -   Request a sample report!

Segment Overview 

This gender reassignment surgery market report extensively covers market segmentation by  

• Type  
• 1.1 Male to female
• 1.2 Female to male
• End-user  
• 2.1 Hospitals
• 2.2 Clinics
• Geography  
• 3.1 North America
• 3.4 Rest of World (ROW)

1.1 Male to female-  The gender reassignment surgery market is experiencing significant growth due to increasing societal acceptance and legal recognition of transgender individuals. Companies are investing in research and development of advanced surgical techniques and technologies to cater to this population's unique needs. The market is expected to expand at a steady pace, driven by rising demand and improving accessibility to gender affirming procedures. Businesses are also focusing on providing comprehensive care, including pre- and post-operative support, to ensure positive patient outcomes. Overall, the gender reassignment surgery market presents a promising opportunity for growth in the healthcare sector.

For more information on market segmentation with geographical analysis including forecast (2024-2028) and historic data (2017-2021) - Download a Sample Report

Research Analysis

The Gender Reassignment Surgery Market encompasses various healthcare policies and cultural attitudes towards sex change procedures. These procedures include surgical interventions such as genital reconstruction through hysterectomy and phalloplasty, as well as facial surgeries. From a medical perspective, gender reassignment involves hormone therapy and mental health-related considerations. Ethical concerns and affordability are significant factors influencing the comprehensive healthcare approach to gender perspectives. Medical innovations continue to advance, offering new solutions for those seeking sex reassignment surgery. The population requiring these services relies on specialized healthcare centers to provide access to these essential procedures.

Market Research Overview

The Gender Reassignment Surgery market refers to the industry dedicated to providing surgical solutions for individuals seeking to align their physical identity with their gender identity. This market encompasses a range of procedures, including but not limited to, hormone therapy, gender affirming surgeries such as orchiectomy, mastectomy, and vaginoplasty, and other related treatments. The market caters to the needs of transgender and gender non-conforming individuals, providing them with essential medical services to help them live authentically. The demand for gender reassignment surgeries is on the rise due to increasing awareness and acceptance of transgender rights, as well as advancements in medical technology. The market is expected to grow significantly in the coming years, offering new opportunities for healthcare professionals and organizations specializing in gender affirming care.

Table of Contents:

1 Executive Summary 2 Market Landscape 3 Market Sizing 4 Historic Market Size 5 Five Forces Analysis 6 Market Segmentation

• Male To Female
• Female To Male
• North America
• Rest Of World (ROW)

7 Customer Landscape 8 Geographic Landscape 9 Drivers, Challenges, and Trends 10 Company Landscape 11 Company Analysis 12 Appendix

About Technavio

Technavio is a leading global technology research and advisory company. Their research and analysis focuses on emerging market trends and provides actionable insights to help businesses identify market opportunities and develop effective strategies to optimize their market positions.

With over 500 specialized analysts, Technavio's report library consists of more than 17,000 reports and counting, covering 800 technologies, spanning across 50 countries. Their client base consists of enterprises of all sizes, including more than 100 Fortune 500 companies. This growing client base relies on Technavio's comprehensive coverage, extensive research, and actionable market insights to identify opportunities in existing and potential markets and assess their competitive positions within changing market scenarios.

Technavio Research Jesse Maida Media & Marketing Executive US: +1 844 364 1100 UK: +44 203 893 3200 Email:  [email protected] Website:  www.technavio.com/

SOURCE Technavio

Modal title

Also from this source.

Fitness and Recreational Sports Centers Market size is set to grow by USD 93.8 billion from 2024-2028, Surge in healthcare costs to boost the market growth, Technavio

The global fitness and recreational sports centers market size is estimated to grow by USD 93.8 billion from 2024-2028, according to Technavio. The...

Machine Vision (MV) Camera Market size is set to grow by USD 1.73 billion from 2024-2028, Increased demand in non-industrial sectors to boost the market growth, Technavio

The global machine vision (MV) camera market size is estimated to grow by USD 1.73 billion from 2024-2028, according to Technavio. The market is...

Health Care & Hospitals

Medical Pharmaceuticals

Get doctor listing on ClinicSpots.

Gynecologist

Cardiologist

Get answers for your health queries from top Doctors for FREE!

100% Privacy Protection

We maintain your privacy and data confidentiality.

Verified Doctors

All Doctors go through a stringent verification process.

Quick Response

Reduce Clinic Visits

Save your time and money from the hassle of visits.

How much does male to female (MTF) surgery cost in 2024?

Explore the interactive cost guide below for detailed pricing information on a range of MTF surgeries and compare costs in different countries.

• Transgender Surgery

Did you know? 

In 2024 , there is a high demand for gender-affirming surgeries. Recent data shows a 25% increase in interest in MTF surgery, highlighting the changing landscape of accessible and affordable care.

Sex reassignment surgery is a procedure enabling individuals to transition to their self-identified gender, typically involving hormone therapy. Male-to-female (MTF) reassignment surgery includes 'top' and 'bottom' surgeries, as well as facial feminization. In some places, like India, it's on the rise due to affordable costs, with an average MTF surgery cost of $2438 to $6095 .

Looking to gather information about the costs associated with personalized treatments from a t op plastic surgeon ? Don't hesitate.

You might be wondering why hormone therapy is necessary in male-to-female surgery. Read on to discover all the details.

In hormone therapy, female hormones like estrogen and progesterone are injected into male bodies to foster a more feminine appearance. Anti-androgens are incorporated due to higher male androgen production. Male-to-female transgender hormone therapy costs approximately $30 per month, with therapist visits averaging around $100 .

Let's read ahead to what male-to-female gender reassignment surgery costs.  

What does MTF top surgery cost?

Breast augmentation and implant surgery are the initial steps in the male-to-female gender reassignment process. Through this transformative procedure, one can effortlessly obtain the desired breast size. This method encompasses both the insertion and placement of implants, ensuring a comprehensive augmentation. The cost for this procedure may fluctuate depending on the chosen hospital and surgeon.

The MTF Breast augmentation surgery cost is given below:  

What is the male-to-female (MtF) bottom surgery cost?

The cost of male-to-female (MtF) bottom surgery, a vital step in the journey of gender affirmation, can vary depending on several factors. These factors may include the specific type of surgery chosen, the geographic location of the surgical facility, and individual healthcare providers' fees. 

Here, we provide an overview of the estimated costs for common MtF bottom surgeries:

What is included in facial feminization surgery, and what is its cost?

Facial Feminization Surgery (FFS) is a transformative cosmetic procedure that aims to soften and reshape male facial characteristics into more feminine features. This comprehensive surgery involves a series of procedures, including lip and cheekbone augmentation, hairline adjustment to reduce forehead size, and sculpting of the jaw and chin. The goal is to harmonize and enhance facial traits for a more feminine appearance.

The total Male to male-to-female feminization surgery cost may go up from $9,000 to $12,000. 

Do you know Robotic surgery is an effective alternative to traditional penile inversion and Vaginoplasty in transgender cases. It utilizes small tools on a robotic arm, marking a revolutionary advancement in surgery.

Take charge of your health and your life.  Contact us today!

If you're curious about the expenses of male-to-female sex reassignment surgery across various countries, let's explore further. Keep reading to find out more.

Factors affecting the cost of male-to-female surgery

The number of surgical procedures performed for gender reassignment is on the rise. With the surge in cases, the male-to-female surgery cost is also becoming more affordable and nominal in Asian countries compared to other nations. However, a few factors still affect the total cost of surgery.

• Lack of insurance coverage from major companies
• Pre and post-operative charges
• Pre-operative counselling charges (if required)
• Hormonal Therapy charges
• Hospital charges
• Doctor’s fee for all the different treatments
• Higher costs or prices for cosmetic surgery procedures such as facial feminization surgery.

Your well-being is our priority -   call us to book your appointment today

Insurance and Financing for MTF Surgeries 

Insurance and Financing for MTF Surgeries Gender-affirming surgeries, such as those involved in male-to-female (MTF) transitions, often come with associated costs. Understanding your insurance coverage and financing options can greatly aid in managing these expenses.

• Insurance Coverage: Review your policy for coverage of gender-affirming surgeries.
• Medicaid and Medicare: Some states offer coverage through these programs.
• Out-of-Pocket Costs: Plan for co-payments, deductibles, and uncovered services.
• Financing Options: Explore personal loans, medical financing, and crowdfunding.
• Consultation with Experts: Seek guidance from experienced healthcare providers.

1.) How long does a male-to-female transition take? Some transitions may take less than a month, and some can even take years. It mostly depends on the mental and physical health of the person and what kind of treatment you are involved in.

2.) How long does it take to grow breasts on estrogen?

The estimated time to grow breasts through estrogen is 2 to 6 months. It also depends on factors like fatty tissue levels, body genetics, etc.

3.) How long does it take to recover from male-to-female surgery?

It takes an average of 2 to 8 weeks to recover from male-to-female transition surgery. However, penectomy and vaginoplasty are major surgeries that need more care and usually take longer to recover.

4.) Can I undergo MTF transition without surgery?

Yes, many individuals choose to undergo MTF hormone therapy and other non-surgical procedures to achieve their desired gender expression without surgery. It's essential to discuss your options with a healthcare provider.

5.) What is the typical duration of hormone therapy for MTF transition?

The duration of hormone therapy varies from person to person. Typically, individuals undergo hormone therapy for an extended period, often lifelong, to maintain their desired physical and emotional changes. Your healthcare provider can provide more personalized guidance.

Health Tips, Health Care and Fitness Tips, Health News | TheHealthSite.com

National Center for Biotechnology Information (nih.gov)

https://my.clevelandclinic.org/health/treatments/21526-gender-affirmation-confirmation-or-sex-reassignment-surgery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994261/

Related Blogs

Transgender Body Dysmorphia: Treatment Insights & Options

Empathetic support for transgender body dysmorphia. Therapy, understanding, and community aid self-acceptance.

Gender Reassignment Surgery Cost (MTF & FTM)

Explore the rising demand for gender reassignment surgery worldwide. Learn about the various procedures and their detailed costs in this comprehensive article.

Post-Op Transgender Genitalia: Recovery and Care

Understand post-operative care for transgender genitalia surgery. Learn about recovery, potential complications, and lifestyle adjustments for optimal healing and well-being.

List of 15 Best Transgender Surgeons in the World 2024

Explore top transgender surgeons globally. Access expertise, compassionate care, and personalized treatment for gender-affirming surgeries, ensuring optimal results and well-being.

Hormone Therapy for Transgender Youth: Comprehensive Care

Explore hormone therapy for transgender youth. Learn about its benefits, risks, and importance of comprehensive medical and mental health support for a safe and affirming transition journey.

Transgender Surgery in India: Navigating Transformation

Discover top-quality transgender surgery in India. Expert surgeons, compassionate care, and life-changing results await. Embrace your journey today.

Fertility Preservation Before Transgender Surgery

Are you willing to change your gender but also conscious of becoming a parent? Don't worry we have discussed fertility preservation before transgender surgery.

Gender Reassignment Surgery and Aging

Explore how gender reassignment surgery impacts aging. Learn about preservation options & navigate this personal journey.

Question and Answers

I am a 32 years old male who has got into cross dressing some 8 years back, now my urge of being like this has grown, last two years I have been I’m eating dian35 prescribed by a doctor in Malaysia, but now I believe I shall be needing more strong dose since the transformation is already 2 years and can see few changes

It seems like you may be going through some changes about turning into the opposite sex. Understand that these changes are complicated and might need some medical interventions. You might require different amounts of hormones to help you through the process. Talk about what is bothering you and your symptoms with a doctor who can help you figure out the best way forward.

Answered on 25th June '24

Dr. Vinod Vij

I'm a 56 year old transgender female and I was taking hormones but had to stop because I just couldn't afford them anymore. I want to take the Opill birth control because of the progestin in it to help increase my breast size even though it will take time. My question to you is will taking the Opill birth control hurt me if I take it long term or will I be fine.

Starting the Opill birth control for breast enlargement can be risky. Use of birth control pills for a long time can cause problems such as high chances of blood clots, weight change, and emotional state. The hormone progestin in the pill can affect my levels of hormones. There are also claims that birth control pills made of progestin can affect the production of hormones. Consult your healthcare provider to make a safe decision and avoid risking negative consequences. 

Answered on 23rd May '24

I am 22 years male. I have gender identity issues. I feel like I don’t fit to this gender.

It is a common thing for lots of people­ to feel they do not be­long to the gender the­y were given at birth. This is calle­d gender dysphoria. The signs might include­ feeling weird about your body, clothe­s, or pronouns people use for you. This happe­ns because your gende­r identity does not match the se­x you were marked at birth. Spe­aking to a therapist who gets gende­r identity can help you in finding ways to feel good and supporte­d. 

Will those who are transgender have children?

Transgende­r individuals face challenges in naturally conce­iving due to medical aspects. Those­ assigned female at birth and on hormone­ therapy may have lower fe­rtility. Those assigned male at birth typically cannot ge­t pregnant. Preserving e­ggs or sperm before transitioning may he­lp those wanting biological kids later. Consulting fertility e­xperts can help transge­nder people de­siring parenthood.

Dr. Pradeep Mahajan

Currently I am a woman. Born on 17-09-1989. I want to transition from girl to boy. Is it possible? How much will it cost? And whether there are any physical complications later?

Female | 35

Going from girl to boy occurs when pe­ople take hormones and have­ operations. The total cost depe­nds on what treatments are chose­n. After, problems could be infe­ctions, scars, and fertility changes. Talking to a transgende­r doctor regarding options and risks is crucial.

Transgender Surgery Hospitals In Other Cities

Top related speciality doctors in other cities.

• Today's news
• Reviews and deals
• Climate change
• 2024 election
• Fall allergies
• Health news
• Mental health
• Sexual health
• Family health
• So mini ways
• Unapologetically
• Buying guides

Entertainment

• How to Watch
• My Portfolio
• Latest News
• Stock Market
• Biden Economy
• Stocks: Most Actives
• Stocks: Gainers
• Stocks: Losers
• Trending Tickers
• World Indices
• US Treasury Bonds
• Top Mutual Funds
• Highest Open Interest
• Highest Implied Volatility
• Stock Comparison
• Advanced Charts
• Currency Converter
• Basic Materials
• Communication Services
• Consumer Cyclical
• Consumer Defensive
• Financial Services
• Industrials
• Real Estate
• Mutual Funds
• Credit Cards
• Balance Transfer Cards
• Cash-back Cards
• Rewards Cards
• Travel Cards
• Credit Card Offers
• Best Free Checking
• Student Loans
• Personal Loans
• Car Insurance
• Mortgage Refinancing
• Mortgage Calculator
• Morning Brief
• Market Domination
• Market Domination Overtime
• Asking for a Trend
• Opening Bid
• Stocks in Translation
• Lead This Way
• Good Buy or Goodbye?
• Fantasy football
• Pro Pick 'Em
• College Pick 'Em
• Fantasy baseball
• Fantasy hockey
• Fantasy basketball
• Download the app
• Daily fantasy
• Scores and schedules
• GameChannel
• World Baseball Classic
• Premier League
• CONCACAF League
• Champions League
• Motorsports
• Horse racing
• Newsletters

New on Yahoo

• Privacy Dashboard

Yahoo Finance

Gender reassignment surgery market size is set to grow by usd 369 million from 2024-2028, increase in number of people opting for sex change surgeries globally boost the market, technavio.

NEW YORK , June 28, 2024 /PRNewswire/ -- The global gender reassignment surgery market size is estimated to grow by USD 369 million from 2024-2028, according to Technavio. The market is estimated to grow at a CAGR of over 11.92%  during the forecast period. Increase in number of people opting for sex change surgeries globally is driving market growth, with a trend towards advancements in medical technology. However, high cost of surgeries  poses a challenge. Key market players include Andrew Ives ., Boston Childrens Hospital, Boston Medical Center, Chettawut Plastic Surgery Center, CNY Cosmetic and Reconstructive Surgery, Crane Center, Icahn School of Medicine at Mount Sinai , IVAN MANERO CLINIC S.L., Moein Surgical Arts, Oregon Health and Science University, Phuket International Aesthetic Centre PIAC, Plastic Surgery Group of Rochester , Regents of the University of Michigan , Rumer Cosmetic Surgery, Sava Perovic Foundation Surgery, The Johns Hopkins Health System Corp., Transgender Surgery Institute, and University of Pennsylvania Health System.

Get a detailed analysis on regions, market segments, customer landscape, and companies-  View the snapshot of this report

Market Driver

The global gender reassignment surgery market is experiencing significant growth due to advancements in medical technology. Innovations include minimally invasive surgical techniques, improved medical devices, imaging technologies, and perioperative care practices. These advancements offer benefits such as smaller incisions, faster recovery times, and enhanced patient experiences. Tissue engineering and regenerative medicine also hold promise for enhancing surgery outcomes. Anesthesia and pain management advancements optimize patient comfort and reduce complications, contributing to market growth. Healthcare providers leverage these technologies to meet the increasing demand for gender-affirming treatments and improve transgender individuals' quality of life.

The gender reassignment surgery market is experiencing significant growth due to increasing acceptance and awareness of transgender rights. Quite a number of people undergo this procedure to align their physical appearance with their gender identity. The services involved include hormone therapy, surgeries such as chest reconstruction and genital reassignment, and other related procedures. The cost of these procedures can be substantial, but many countries offer coverage under their healthcare systems. The industry is also seeing advancements in technology and techniques, making the procedures safer and more effective. Additionally, the availability of financing options and support groups is helping more individuals access these services. Overall, the gender reassignment surgery market is poised for continued expansion in the coming years.

Research report provides comprehensive data on impact of trend. For more details-  Download a Sample Report

Market Challenges

The gender reassignment surgery market involves significant expenses, including hormone therapy, counseling, and living as a target gender in the year preceding the procedure. The cost of the surgery itself ranges from USD0.2 - USD0.8 million , depending on the transition type. Ongoing costs, such as hormone therapy and doctor visits, add to the overall expense. A year of therapy with a psychologist, required before physical transition, costs USD1,000 - USD1,500 per session, totaling USD48,000 - USD72,000 . These high costs may hinder market growth during the forecast period.

The Gender Reassignment Surgery market faces several challenges. Healthcare providers offer various procedures such as hormone therapy, surgeries, and counseling services. However, access to these services can be a concern for many individuals. Costs for gender reassignment surgeries can be high, making it difficult for some to afford. Additionally, there are regulatory and legal challenges that can impact the availability and affordability of these services. Furthermore, cultural and societal norms can create stigma and discrimination, making it challenging for individuals to seek out the care they need. Despite these challenges, the market continues to grow as more individuals seek gender affirming care. Companies must address these challenges to provide accessible and affordable options for those in need.

For more insights on driver and challenges -   Request a sample report!

Segment Overview 

This gender reassignment surgery market report extensively covers market segmentation by

1.1 Male to female

1.2 Female to male

2.1 Hospitals

2.2 Clinics

3.1 North America

3.4 Rest of World (ROW)

1.1 Male to female-  The gender reassignment surgery market is experiencing significant growth due to increasing societal acceptance and legal recognition of transgender individuals. Companies are investing in research and development of advanced surgical techniques and technologies to cater to this population's unique needs. The market is expected to expand at a steady pace, driven by rising demand and improving accessibility to gender affirming procedures. Businesses are also focusing on providing comprehensive care, including pre- and post-operative support, to ensure positive patient outcomes. Overall, the gender reassignment surgery market presents a promising opportunity for growth in the healthcare sector.

For more information on market segmentation with geographical analysis including forecast (2024-2028) and historic data (2017-2021) - Download a Sample Report

Research Analysis

The Gender Reassignment Surgery Market encompasses various healthcare policies and cultural attitudes towards sex change procedures. These procedures include surgical interventions such as genital reconstruction through hysterectomy and phalloplasty, as well as facial surgeries. From a medical perspective, gender reassignment involves hormone therapy and mental health-related considerations. Ethical concerns and affordability are significant factors influencing the comprehensive healthcare approach to gender perspectives. Medical innovations continue to advance, offering new solutions for those seeking sex reassignment surgery. The population requiring these services relies on specialized healthcare centers to provide access to these essential procedures.

Market Research Overview

The Gender Reassignment Surgery market refers to the industry dedicated to providing surgical solutions for individuals seeking to align their physical identity with their gender identity. This market encompasses a range of procedures, including but not limited to, hormone therapy, gender affirming surgeries such as orchiectomy, mastectomy, and vaginoplasty, and other related treatments. The market caters to the needs of transgender and gender non-conforming individuals, providing them with essential medical services to help them live authentically. The demand for gender reassignment surgeries is on the rise due to increasing awareness and acceptance of transgender rights, as well as advancements in medical technology. The market is expected to grow significantly in the coming years, offering new opportunities for healthcare professionals and organizations specializing in gender affirming care.

Table of Contents:

1 Executive Summary 2 Market Landscape 3 Market Sizing 4 Historic Market Size 5 Five Forces Analysis 6 Market Segmentation

7 Customer Landscape 8 Geographic Landscape 9 Drivers, Challenges, and Trends 10 Company Landscape 11 Company Analysis 12 Appendix

About Technavio

Technavio is a leading global technology research and advisory company. Their research and analysis focuses on emerging market trends and provides actionable insights to help businesses identify market opportunities and develop effective strategies to optimize their market positions.

With over 500 specialized analysts, Technavio's report library consists of more than 17,000 reports and counting, covering 800 technologies, spanning across 50 countries. Their client base consists of enterprises of all sizes, including more than 100 Fortune 500 companies. This growing client base relies on Technavio's comprehensive coverage, extensive research, and actionable market insights to identify opportunities in existing and potential markets and assess their competitive positions within changing market scenarios.

Technavio Research Jesse Maida Media & Marketing Executive US: +1 844 364 1100 UK: +44 203 893 3200 Email:  [email protected] Website:  www.technavio.com/

View original content to download multimedia: https://www.prnewswire.com/news-releases/gender-reassignment-surgery-market-size-is-set-to-grow-by-usd-369-million-from-2024-2028-increase-in-number-of-people-opting-for-sex-change-surgeries-globally-boost-the-market-technavio-302185319.html

SOURCE Technavio