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Transgender Americans Face Staggering Costs, Even With Health Insurance - YouTube
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Claire: I probably have spent upward
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over $200,000, maybe
$300,000, in just medical.
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It is expensive just
to try to be yourself.
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[Narrator] Claire is among the estimated
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1.4 million transgender
people living in the US,
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where even patients with health insurance
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can face six-figure bills.
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There are surgeries like top and bottom,
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which can cost over $50,000 each,
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hair removal, which costs
hundreds of dollars a month,
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and a slew of other
expenses that most Americans
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never have to think about.
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Lex: Let's really dig into it.
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So, like, let's talk
about surgical binders
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that you might need coming out of surgery.
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Let's talk about...
Emmett: Prosthetics.
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Lex: Prosthetics, let's talk about
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clothing that is comfortable,
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time off.
Claire: Food.
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Lex: Yeah, it's so
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many expenses...
Garnet: Who's going to take
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care of you when you can't work.
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[Narrator] The reality is that being trans
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comes with all kinds of costs.
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If you're trans, your gender identity
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doesn't match your
gender recorded at birth.
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And this can lead to a
form of emotional pain
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commonly called gender dysphoria.
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Garnet: It feels like you're
trapped in a flesh prison.
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Just extreme discomfort,
almost self-hatred.
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[Narrator] For decades,
doctors tried to alleviate
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dysphoria through counseling.
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But it was...
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Dr. Joshua Safer: An abysmal failure.
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We have suicide attempt rates
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of 40% among transgender people.
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And so we know that
that's a failed strategy.
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[Narrator] And that left
doctors with two strategies...
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Safer: Changing the brain to
match the rest of the body,
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or changing the body to match the brain.
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[Narrator] And when you think about it...
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Safer: It becomes pretty
clear that the mucking around
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in your brain is gonna be
the more invasive thing.
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[Narrator] So people like
Garnet, Lex, Claire, and Emmett
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opt for strategy two:
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changing their bodies
to match their brains.
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This process is complicated,
long, and sometimes painful.
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But for many trans people, it works.
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Claire: Being able to transition
literally saved my life.
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My worst day, me, now, as transitioning,
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is better than my best day
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I ever had in my old life,
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when I presented male.
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I'm able to walk out this door
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and just be able to exist
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without fear, without compromise.
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[Narrator] But that doesn't
mean everyone can afford
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these procedures.
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Claire: And it becomes
this to the point where
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you can drown in debt from it.
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[Narrator] How much you pay for healthcare
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largely comes down to insurance:
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whether you have it, and what it covers.
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An estimated 14% of trans
folks are uninsured.
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And for them, a single
gender-affirming surgery
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like vaginoplasty can cost over $50,000.
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But even if you do have insurance,
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you might still have to
pay for care out of pocket.
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That's partly because some insurance plans
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simply don't cover
trans-related surgeries.
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Even though that's illegal
in virtually all cases
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under anti-discrimination laws.
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But there's another reason,
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and it's that many insurers
don't consider certain
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procedures, like facial
feminization or breast augmentation,
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"medically necessary."
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They call them "cosmetic" instead,
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and "cosmetic" tends to be
code for "out of pocket,"
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which is partly why people like Claire
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end up having to empty their savings.
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Claire: They just came
down with a hard no.
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"It is cosmetic."
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[Narrator] That was in 2019,
when Claire tried to get
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insurance to cover a
scheduled breast augmentation.
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Claire: Which now means
that if I want to get
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that procedure, which I feel I need
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just so I can feel more
comfortable with myself
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and just to be able to stand in the mirror
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and look at myself,
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now I'm gonna have to pay out
of pocket for that procedure,
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and that procedure ranges anywhere
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between $12,000 and $18,000.
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[Narrator] And Claire,
she's just one of many.
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In one survey, 55% of
trans people reported
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being denied coverage for
gender-affirming surgeries.
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And that has consequences that extend
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beyond financial and emotional stress.
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Safer: Let's just say, for example,
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facial feminization surgery
for a transgender woman,
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that might be a very necessary surgery.
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But if a significant point for
that individual is to be able
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to walk down the street and
be treated appropriately
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according to her gender identity,
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then having a feminine
face is gonna be enormous
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both for how she's treated
and, frankly, for safety.
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[Narrator] And even if insurance
does cover your procedures,
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there are plenty of other
expenses that most people
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never have to think about.
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If you're a trans man, for example,
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you could invest hundreds
of dollars in binders.
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Lex: Let's talk about binders, right?
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It's this thing that you
put on so that you can
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bind your chest and so that
your chest is not so visible.
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So for a lot of
transmasculine-identified folk
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or trans men, it's super
important to, like,
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not have your chest visible.
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Also it's, like, a matter of safety,
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because I could be well
into my transition,
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and I still have my
chest that can, you know,
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sort of, like, out me.
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Each binder could cost, like, $40.
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[Narrator] And then there are
packers, prosthetic penises,
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which can cost hundreds of dollars each.
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Lex: You know, cis guys don't have to
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pay for their penises, right? So.
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Emmett: They get it for free.
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Lex: Yeah, it comes with
the package, you know,
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whether you like how it looks or not.
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[Narrator] Trans women, on the other hand,
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have a different list of expenses.
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Claire: So the most expensive thing
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for a trans woman is hair removal.
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[Narrator] Especially
if you do electrolysis.
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Claire: It's about $75
to $150 per session,
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just for your face.
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And you can be doing this for anywhere
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between three to seven years.
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Garnet: Yup.
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Claire: Just to get a reduction.
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[Narrator] And then there's
something that both trans men
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and women have to buy.
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Emmett: Because my body changed so much
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when I started hormones, like,
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I grew out of my clothes.
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Lex: Oh yeah.
Emmett: So I had to basically
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buy a whole new wardrobe.
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[Narrator] So that's just it.
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Even without medical procedures,
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trans people might spend
thousands of dollars
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just to be themselves.
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And unfortunately, many of them don't have
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that kind of money to spend.
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The unemployment rate
in the trans community
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is about three times higher
than the national average.
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Plus, nearly a third of all
trans people, including Lex,
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report being homeless at
some point in their lives.
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And the Trump administration
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may be making these issues worse.
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In 2017, Trump announced
a ban on trans troops
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serving in the military,
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which is, of course, a form of employment.
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And in 2019, the
administration wrote new rules
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that will make it easier
for healthcare providers
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to deny treatment for trans people
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if it violates their
religious or moral beliefs.
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But that's not to say the
US hasn't made any progress.
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In 2002, for example, 0%
of Fortune 500 companies
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offered trans-inclusive
healthcare coverage,
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while today nearly two-thirds of them do.
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And a number of states,
like New Hampshire,
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have enacted various pro-trans laws.
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But no matter how the
US continues to change,
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for better or worse,
there's at least one thing
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that seems to always stay the same,
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and that's the unshakeable resilience
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of the trans community.
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Emmett: Trans people are beautiful.
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Trans people are resilient.
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We've existed for a long time.
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We're gonna keep on
existing. That's what we do.
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Garnet: Oh my God, hugs!
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Lex: Wait, wait, wait.
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Claire: So this was awesome.
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