One of my favorite blogs, Neutrois Nonsense, has been featuring various guest bloggers and re-posts about something that has been in the back of my mind for years now and, with reading the series of blog posts, is pretty much at the front of my mind lately:
chest reconstruction surgery.
I haven’t talked much about my transition on this blog, and this post isn’t necessarily about my transition, because this surgery is something I want and need and will get sooner or later. That is not something I feel the need to rant about.
The problem which holds me back is: how to pay for it?
My original plan, cooked up when I was still a student and my family was living off my student loans, was that at some point I would be gainfully employed in a real job with good benefits, and surely, then, I’d be able to afford it?
Well, I’m now gainfully employed in a real job with good benefits–in the exact field I want to be working in. I could rave about how fantastic my workplace is, how great the people I work with are, how it’s everything I could ask for, my dream job, really.
There’s just one tiny problem: a transgender exclusion on my health insurance policy.
The Affordable Care Act is supposed to protect against discrimination, but so far, that hasn’t extended as far as being clearly enforceable against a blanket exclusion of transition-related medical procedures. Which means if I want insurance to pay for it, it’s going to be an uphill slog.
Dr. Meltzer (who is local, which would save a lot of time and travel expense, and who I’m confident knows his stuff) charges $11,000 for this surgery.
Before I can get surgery, I need a letter from a gender therapist. I found one who is actually covered by my insurance (small miracle), though again, with the exclusion, I don’t know if they will actually cover it if I see her. I can assume if I have to see someone out of pocket, it’s going to drain another $1000 from my bank account.
So…$12,000. I can’t at this point justify spending that on myself. I have kids. They are expensive. Our budget is so tight it screams, and my credit card is maxed out. Hopefully I’ll be able to pay it off by the end of the year, but…
$12,000 is a lot of money.
Ravin's Rantings 
Lindsay
March 4, 2016
A transgender exclusion?! That make me so, so angry/sad/upset/outraged.
$12,000 IS a lot of money. But I think it would be worth every penny for you to have the chest reconstruction surgery and feel comfortable with your body. Of course, you have to come up with every penny, which isn’t/won’t be easy. 😦
I really hope this happens for you sooner rather than later. And I’d love to read more about your transition if you’re willing to share. ❤
Jamie Ray
March 4, 2016
The therapist can put down that they are seeing you for “generalized anxiety disorder” or some other bland common affliction that everyone goes to therapy for. Then they can write you “the letter”. The letter is just to cover the surgeon’s butt – so they can claim that they follow WPATH. If your insurance isn’t going to cover it the letter can probably just be very straight forward informed consentish – you are an adult and you know what you are doing and the therapist agrees that top surgery is the best thing for you.
The money is the hard thing (I paid out of pocket) – and will probably take a couple of years to pay down/off and a lot of sacrifice. You may want to look at several options including medical loans, if you can deduct it as a medical expense on your taxes (I did), and taking out an equity loan on your house (if you own). Credit cards (unless you play the transfer the balance game) are probably the most expensive way to pay for it.
ravinj
March 15, 2016
Thanks for the suggestions. I never heard back on the email I sent to that one therapist, I guess I need to break down and actually call her. I am inclined to maintain willful ignorance as far as insurance codes go, if insurance covers it. I looked at the medical loan thing, and I’ll likely only qualify for about half the expense that way (my credit rating is not great). We don’t own a house. Part of my problem is that I have a very newish car loan and pay rent two different places. The money situation might improve slightly in the fall when my son starts school, but that’s also when my student loan repayment amount is going to go up.