How to Pay for Gender-Affirming Surgery
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Americans considering gender-affirming surgery can find themselves at the start of an exciting new chapter but the costs to be steep. For many, managing the expenses related to transitioning requires planning and may call for more than one financing solution.
Wolsey Bradley and his wife, Lucky, had to be creative in financing their procedures. The couple used credit cards, medical credit cards, cash and insurance to pay for nearly $50,000 in medical expenses related to their transitions.
"We’ve probably paid for our surgeries in every way you can think of," Wolsey says.
Borrowing money or financing a procedure can also be an option when savings or insurance doesn’t cover all the costs.
How much does gender-affirming surgery cost?
The price tag for individual gender-affirming surgical procedures can range from $8,000 to $64,000, according to 2022 research in the Journal for Law, Medicine and Ethics. The cost generally covers the surgeon’s fee, facility costs, anesthesia fees, medical tests, medication and post-surgery needs, depending on the type of procedure.
For people who need a series of procedures, the combined expenses can reach six figures.
Ways to finance gender-affirming surgery costs
The best-case scenario is for health insurance to cover the costs of gender-affirming surgery, also known as gender-confirmation surgery. If that’s not an option, other ways include personal loans and credit cards. Consider these options to pay for gender-affirming surgery and care:
Online personal loan
Online lenders offer unsecured personal loans that can be used for almost any purpose, including medical costs. Loan amounts range from $1,000 to $100,000, and interest rates and monthly payments are fixed over the life of the loan.
Online lenders typically let you pre-qualify and apply for a personal loan online, and some loans have next-day funding. However, online loans can be one of the most expensive ways to cover gender-affirming surgery costs. Compare the annual percentage rates (APRs) of multiple lenders to receive the best rates and monthly payments that fit your budget.
Use our personal loan calculator to see estimated rates and monthly payments.
Whom it’s best for: Borrowers who qualify for a low rate and prefer an online experience.
» MORE: Compare medical loans
Credit union personal loan
Credit unions also offer personal loans, often with lower rates and more flexible terms than those of online lenders. Like online lenders, credit unions set loan terms based on your credit score and history, but some may consider factors outside your credit score, making it easier to qualify for funding. The loan amounts offered may not cover the total cost of surgery, and you must qualify for credit union membership.
Whom it’s best for: Credit union members and those with thin or imperfect credit histories.
Credit card
Credit cards are one way to cover a small procedure or a portion of a costlier surgery, but interest rates can be high.
If you have good or excellent credit (a score of 690 or above), you could be eligible for a credit card with an introductory 0% APR. There is no interest during the card's promotional period, which can usually last 15 to 21 months. You have to pay off the balance within the promotional period to avoid paying interest.
When using a credit card, ensure that your medical costs don't reach the credit limit, which can negatively affect your credit score.
Whom it’s best for: Cardholders with a comfortable amount of credit available and who are looking to pay for minor procedures.
CareCredit
Wolsey says he used CareCredit to help cover $5,000 of his nearly $15,000 chest reconstruction surgery cost. CareCredit is a credit card used specifically for financing health care expenses. If your doctor accepts it, you can apply at their office or online.
CareCredit offers attractive zero-interest promotional financing for a designated term, but unlike most 0% APR credit cards, it defers interest. That means if you don’t pay your balance within the promo period, you must pay all your interest retroactively from the date of purchase. CareCredit’s standard APR is 29.99%, which may be higher than the rates of other credit card issuers.
Whom it’s best for: Individuals who need help covering a small procedure or a portion of a larger procedure and can pay off the debt within the promotional period.
Home equity line of credit
If you own a house, a home equity line of credit allows you to borrow against it, sometimes up to 85% of its appraised value minus any amount you still owe on the mortgage. You can borrow and repay the funds as often as needed during the term, and highly qualified borrowers may get lower APRs.
However, you could lose your home if you can’t repay the HELOC. Interest rates are usually variable, so monthly payments could fluctuate, and some HELOCs have closing costs, an appraisal fee or other fees.
Whom it’s best for: Homeowners with equity in their homes who are unsure of the total cost or number of procedures they’ll have and want flexible credit to draw from.
Family loan
A no-interest or low-interest loan from a relative may be an affordable and lowest-risk option. However, it’s worth weighing the potential impact of this arrangement on your relationship with the family member. Formalizing the process with a promissory note — a document that details factors like interest and repayment terms — and consulting a tax preparer can help make the feeling of borrowing from family easier.
Whom it’s best for: Those looking for a low-cost way to pay for the procedures and who feel comfortable borrowing from family members.
Other ways to cover gender-affirming care costs
Surgery grants
Some foundations and organizations offer grants — funds that don’t need to be repaid — for gender-affirming surgery. The Jim Collins Foundation, Point of Pride and Genderbands are examples of organizations that offer funding. Check their websites for eligibility requirements and application deadlines.
Flexible spending accounts
Your employer-provided insurance may allow you to contribute to a flexible spending account, up to $3,050 annually. The money in an FSA isn't taxed and can be used to pay out-of-pocket health expenses like co-pays or prescriptions.
Payment plan
Some health care providers allow you to set up payment plans that break up large medical bills into more affordable monthly payments. The total monthly payment depends on the procedure’s cost and terms you negotiate with your health care provider, and there may be billing charges or fees associated with the plan.
Additional tips: Compare and plan
After managing thousands of dollars in medical expenses — and spreadsheets to track them — Wolsey and Lucky have found additional ways to save on costly surgeries.
Don’t always choose the cheapest option
It may be tempting to shop based on price alone, but it benefits you to find a reputable surgeon with experience in the procedures you need. Working with someone unsuitable could mean you’ll have to pay someone else to fix mistakes — something that Lucky has witnessed in her community.
“I had a couple of friends who went with a cheaper surgeon just because it was less money, and they ended up spending a lot more because other surgeons had to fix it," she says.
Compare options
Having multiple options allows you to make the best decision for yourself and your budget.
"You can go into any surgeon’s office and get them to give you a quote. It’s like buying a car," Wolsey says. Through this approach, Wolsey and Lucky found a surgeon who performed the procedures they needed at a more affordable price.
“The surgeon who did my first bottom surgery and Lucky’s final round of facial feminization surgery does time on the table. She does not charge for each individual procedure she does.”
Budget and plan
Before you take out a loan or apply for a credit card, add the monthly payments into your budget to determine whether you can afford them.
“I think financially you really have to check what you have. You have to be really aware of how well you are budgeting and paying off debt,” Wolsey says.
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