My partner and I have been married for just over two years now. When we got married, she was male-presenting, and it felt like we were a fairly typical millennial couple. We had a nice chunk of student loan debt and little savings starting out. We had fairly conventional goals: buying a home with a 20% down payment, paying for our wedding and honeymoon (about $15,000 of expenses), paying off our debt, and, eventually, starting a family. We both have reasonable spending and saving habits, so all of our financial goals seemed well within reach.
A few months after our wedding, our plans hit an unexpected complication. My partner told me that she had been struggling with feelings of dysphoria around her (then-male) gender presentation. She wanted my blessing to begin therapy to explore her gender. This conversation began a personal journey for her (and for us) that ultimately resulted in her coming out as a transgender woman. The outcome has, it turns out, been great for both of us, and she is so much happier and our relationship is stronger than ever. It also hasn’t been without some significant expenses on our part.
For anyone beginning a transition journey, these expenses vary widely depending on the age when a person transitions, their personal preferences and needs around medical procedures, and their access to insurance coverage and healthcare options. As a privileged middle-class upwardly-mobile couple, we had the money for many expenses, but we also (ironically) saved a lot of money specifically because of our privilege, which afforded us with exceptional healthcare.
Here is a breakdown of all of the quantifiable expenses that we incurred relating to the first two years of her transition journey:
There will be more expenses to come, especially when she obtains a court order for legal name and gender changes and as we look into family planning. But the first two years have been, I think, the most expensive part of the process.
(Special thanks to my partner, Claire, for her help pinning down the cost of each item and for her help with the specific language used throughout.)
Counseling Services: $2,932.00
I saw a therapist every month for about two full years to process my emotions around her transition and what it meant for our future, and to cope with the impact it had on my relationship with my very conservative Evangelical family. Claire has seen her therapist about every two weeks for about two years, and now has reduced the frequency to once a month. Due to changes in insurance, our copays varied from $20 per session to $68 per session.
Fertility/Reproductive Expenses: $180.00
- Consultation and Testing: Covered by Insurance
- Initial Deposits: Covered by insurance
- Ongoing Storage: $180/year
One of the biggest complications around Claire’s transition was the difficulty it introduced into our family planning. Hormone replacement therapy for transitioning (unsurprisingly) renders many trans people unable to conceive without medical intervention. We both want kids, and while we are open to adoption, we want to retain as many options for family planning as possible. We underwent fertility testing, and then she froze several vials of sperm.
Of course, the most expensive part of this process won’t occur until we begin our family, but it’s worth noting that this particular category was where insurance helped the most. All of our testing was 100% covered, and even her initial sperm deposits were covered. We have only had to pay for the ongoing storage, and it would have been vastly more expensive without great medical insurance.
Medical Visits and Testing: $158
Claire goes to a great trans-inclusive clinic in Pittsburgh where they keep a close eye on her hormone levels, so she gets blood work every six months, in addition to a general check-up every six months as well.
Hormone Replacement Therapy: $260
My partner, like many trans women, takes an estrogen supplement as well as a testosterone blocker. She only started them one year ago and this expense will likely last her entire life.
Voice Therapy: $490
One thing HRT does not help to feminize is a male-typical voice. Many trans women might try to develop a female-passing voice on their own, or they may rely on apps to help them to train their voice. Luckily, Claire had access to a trans-focused vocal coaching program through the local university medical center. All seven voice therapy sessions had to be paid out of pocket.
Legal Representation: $1,000 Retainer
We secured the services of a local attorney for help with the legal part of the transition process and, possibly, for help with adoption services down the road. This fee covers her assistance in name and gender changes, which will require a court order.
Legal Document Changes: $165
Claire has changed her gender marker on some documents that don’t require a court order, such as her driver’s license and passport. These documents will need to be changed again once her legal name is changed. This sum doesn’t include fees to change other documents down the road, including deeds, our marriage license, her college diploma, and many others that we probably have yet to consider.
Laser Hair Removal: Approximately $3,000
Laser hair removal on her face was important to her, since she has dark hair and was extremely self-conscious about having a visible shadow — even one she could cover with makeup. This expense has varied some, but she’s had seven sessions now, with probably at least one more to come. This only includes the cost of LHR on her face, chest, and lower back.
Initial Cost to Begin a Makeup Routine and Curate a Women’s Wardrobe: $1,850
- Makeup Lesson: $90
- Startup Makeup Purchases: $300
- Clothing to Build Female Wardrobe: $1,190
- Women’s Shoes: $270
Calculating the cost of the transition wardrobe is hard because she doubtless would have needed to purchase clothes even without transitioning, but building a complete professional women’s wardrobe from scratch is something different, so I’ve included a rough estimate of her clothing purchases over the last two years. I also wear very minimal makeup and she has a much different complexion than me, so she went to a professional to learn how to choose and apply makeup, which gave her the confidence to begin wearing it to work daily after coming out at work.
She worked hard to keep these expenses low, shopping largely second-hand. But it still adds up when you’re developing a whole set of makeup and professional and leisure wardrobes, all from scratch. And some clothing items for trans women are more specialty items that have to be custom-ordered or purchased from specialty clothiers.
Total Cost (in the last two years): +/- $10,035
I will say that every penny we’ve spent, and every obstacle placed in the way of our financial and family goals, has been 100% worth the money for my partner’s emotional wellbeing, sense of fulfillment, and for the health of our relationship, which has deepened and become stronger over these two years. I would not take back a single expense.
However, we both acknowledge that her transition has very much been facilitated by the level of privilege afforded by our socioeconomic status. We both grew up in poor communities, so we are very aware that her transition would have gone very differently if she weren’t a college-educated high-earning software developer, and if I didn’t have a good, professional job that provided good health insurance for both of us. I make a little bit over $50,000/year at my primary job and also pick up side hustles throughout the year, and she makes a little over $80,000/year — a tidy sum for two fairly frugal people living in Pittsburgh.
Not every trans person or queer couple in the U.S. has the same level of privilege. Therefore, it’s important that we, as a society, acknowledge the legitimacy of trans people with low incomes. A trans woman who can’t afford laser hair removal or a trans man who can’t afford top surgery is no less a woman or man than someone who can access those resources. If you’re reading this and you are trans and are worried that your limited income and access to resources means that you will never pass, or that you won’t be seen as a “real” woman or man, I want to tell you that, regardless of any other factors, you are legitimate, no matter how you present or how you wish to be seen.
There are resources for trans people with lower incomes. If you are trans but have limited financial resources, check out the National Center for Trans Equality. If you are a person with privilege, I encourage you to donate to causes that champion trans rights to ease the burden for those who can’t afford the hefty price tag my partner and I were able to cover.
Hannah (She/Her) is a teacher and tutor living in Pittsburgh, Pennsylvania. She loves to read and tries to live simply, hiking on weekends and traveling to interesting places whenever possible. She is working on perfecting vegetarian recipes that will delight her omnivorous partner and friends.
Image via Unsplash