Hmmm. Since i’ve been getting a few questions about this in comments and in private e-mails, let’s get this set out once and for all.
If you go private, the following are the sort of costs you are likely to hit along the way, assuming you can’t get your pct to fund ANY of it. I’ll blog separately about that, since once you know what you’re about, you may be able to get them to pay for specific items.
Start with a specialist
First off is a visit to a specialist (I used Richard Curtis, but there are others at similar price levels). He diagnosed gender dysphoria (which had already been disgnosed by my local NHS psych service, so that helped) and said i needed one of two things before i started hormone therapy: three months real-life experience, or equivalent therapy.
I went belt and braces and did both, though in hindsight would not recommend the therapy. More on that later.
The specialist costs are approx. £240 per hour and i’d estimate i had one hour session and three to four half hour sesions…so we’re talking around £700.
Dubious benefits of therapy
Therapy was, i think, six sessions at around £40 per hour. Why would i not recommend it? At the time, i was still viewing the whole process through NHS goggles, and that view is that this is a mental health/psych led process. What i know now is that if you know, you know and personal therapy – at least around gender issues – turned out to be thoroughly irrelevant for me. Not just my experience, but that of several other trans women i know now, as well.
There is an argument for some therapy a) for nearest and dearest, for whom the process can be quite traumatic and b) around other issues. There is/was, for me, a degree of grief at not having been born female which i deal with, slowly.
Keep taking the tablets
Once past the initial assessment, you are into hormone territory. I tried patchesw first and then went on to pills. The patches didn’t work too well and i paid for my first battch of patches (£45 for three months supply): that was impetuous as i could have had them on the NHS.
Your pills or whatever are likely to cost you about £10-£15 per month – but if your GP is prepared to put them on prescription then you may make considerable saving there. Depends on GP and even part of the country: i am told that Camden pct still refuses to allow their GP’s to prescribe hormones, even where these have been initially prescribed by Charing Cross. That is a bit of NHS stupidity and hopefully will be resolved in time.
In addition to feminising hormones, you may add on something like Finasteride (if you have a receding hairline) and, when the testosterone starts to fight back, you will probably need an anti-testosterone jab or implant. That can be much pricier: my own (triptorelin) cost about £150 for a three-month jab – though again, it went through on prescription (each time with a practice sticker warning it was an expensive item).
Under the knife
You are eligible for grs 12 months after you commence hormones and assuming you have lived full-time rle. I’ve hardened. There have been scary moments along the way – some very scary indeed – but if you are serious about what you want, you will go rle and stay there.
I think there are good medical reasons for going sooner rather than later, and i’ll go into those later, too.
The op at Brighton was a flat £10,500, including some follow-up and dealing with the main complications. I understand from others that if you go to places like Thailand, you MAY spend less, even allowing for planes and hotels, but i am not an expert on that. In the end, what swung the choice for me was the thought of having to deal with complications. I don’t think i could handle going back to Thailand whilst, say, suffering major pain.
Preparing for surgery
Other things you NEED to invest in: you absolutely need your genital area electrolysed – and (my bad, this) it will take time. If you are uncircumcised, you will prob’ly get what is called a penile inversion and this requires far less electrolysis than the full penile-scrotal inversion that those who have been circumcised need. Allow anywhere between four and a dozen sessions…bear in mind most won’t treat you without a four-week gap between treatments and you see the issue. If you’re hairy, electrolysis can hold you up.
At £80-£90 per hour of electrolysis, this bit of your treatment can cost anywhere between £200 and £800…
You will also absolutely need to invest in a final opinion before you go under the knife. As i understand it, this only needs to be a “second professional opinion” and, if honest, is there to protect the back of the surgeon. I dopn’t know how wide you could draw this opinion (GP, perhaps…next door neighbour who happens to be a barrister?) but if you go the usual route and spend on a psych opinon of some sort, expect this to set you back £200-£400.
In summary, getting from start to finish inside a year to 18 months is likely to cost you (privately):
GRS £10, 500
Final opinion £200-£400
That comes in at around £12k – and slightly less if you can get your pct to pick up some components – and maybe £14k tops if things don’t go to plan. I’ve not included therapy which could be anything from zilch to a couple of thousand!
Other stuff you may wish to invest in are personal electrolysis – for own body hair – and speech therapy. And if you are serious about looking good, you’ll possibly find your hair and make-up bills a bit larger than you are used to.
Keep the questions flying.