One of the biggest stumbling blocks facing most transsexuals is financing surgery. Other expenses, like hormones and electrolysis, can be paid for as you go, and don’t represent the financial and psychological barrier of several thousand dollars in surgeon, hospital, and anesthesiology bills.

People living in countries without socialized medicine that covers transsexual surgeries, and those with insurance that excludes SRS, are stuck paying the bills themselves. These are a few of the ways that you might pay for your surgery:

Loans

With the current boom in the popularity of cosmetic surgery of all kinds, a new kind of loan has appeared on the market: the loan marketed to people who want cosmetic surgery, but don’t have the money saved. An internet search of “cosmetic surgery loan” yields the websites of dozens of companies that will finance your surgery, provided it can be done by a cosmetic surgeon. Mastectomy, breast augmentation, and other surgeries that masculinize or feminize your appearance can be performed by plastic surgeons, and financed in this manner. For other types of surgery, you may need to consult with the individual loan company to determine whether they will cover the cost. You may need to use a surgeon that the company chooses. You’ll also need good credit to qualify for a loan, and be able to pay the loan back. Interest rates vary, so shop wisely and read the contract carefully before signing.

Several students of my acquaintance have used the windfall of their student loans to pay for surgery. Through careful planning and budgeting, they managed to save enough money to pay for their classes and books, and earn their living expenses through the semester, so they could use the several thousand dollars they received for those expenses to pay for surgery instead. Remember that if you accept your loan check but don’t take on the courseload you indicated in your loan application, you can get in serious trouble. Get out your loan agreement and read it to make sure you don’t violate their rules.

Grants

There are organizations that provide grant money to needy individuals to pay for medical care. Foundation Grants to Individuals lists such grants; the book is also available on CD-ROM and according to the Foundation Center in New York City, will be available online in June. The book is expensive, so I recommend finding it in your local library or through an organization near you (such as the Foundation Center) that helps non-profit organizations find grants. I haven’t heard of anyone who has tried this method, but it’s worth a try.

Windfalls, Planned or Otherwise

Inheritances, the sale of a home or car (without purchasing replacements of similar or greater value), and big tax refunds are other ways to quickly get the cash you need to pay for surgery. By having your employer withhold more taxes than you would normally owe, and vigilantly finding and applying deductions and credits on your tax forms, you can nearly painlessly save the money you’ll need, and have it paid out to you in a tax refund. Of course, this way you’re not earning any interest on your money, so if you are constitutionally able to sock away money every paycheck into an interest-bearing account, that’s clearly the better route.

Many employers offer medical savings accounts and investment accounts. With a medical savings account, you have your employer withhold before taxes some of your earnings from each paycheck. The money has to be spent within the year, so plan accordingly. Investment accounts such as 401(k) plans can be borrowed against for medical purposes as well, and aren’t subject to the same restrictions as your insurance policy. Talk to your benefits director or the human resources office about your company’s medical savings and investment benefits, and whether either can be used to pay for SRS.

It’s well-known that some trans people have allowed well-off lovers to pay for their surgery. Let your own ethics rule your decision, and beware of being in someone’s debt.

The Old Fashioned Way

I’ve heard some amazing stories of sheer endurance in saving for surgery. One person emptied all the change from his pockets every night into a “surgery jar.” Another bought short-term certificates of deposit (CDs). Others restricted their spending by going out less often or quitting smoking or drinking, and put the saved money into an account to pay for surgery. Still others have staged their own benefit events, putting on drag shows, open mics, and other events at public venues in order to raise cash. Talk to your employer, the owner of the bar you frequent, or the local GLBT center about it: it might prove feasible if you have a talent or can solicit friends to perform for your new chest or genitals.