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Transitioning Genders Can Lead to Steep Medical Costs, Experts Say

iStock/ThinkstockWith Caitlyn Jenner making her high-profile debut on the cover of Vanity Fair on Monday, experts say the newly-minted transgender icon may help shed light on the financial and medical difficulties of transitioning genders.

While Jenner likely has vast financial means to pay for gender reassignment or “gender affirming” surgery, many other people transitioning genders are often without the means to easily pay for the surgeries or hormone treatments that can run in the tens of thousands of dollars, experts say.

Kylie Aquino, the president of the Jim Collins Foundation, a nonprofit group that grants funds to individuals seeking gender-affirming surgery, said she’s “proud” of Jenner but is concerned that people will not realize how exceptional her story is.

“I’m happy for Caitlyn, [but] I don’t want her narrative to be perceived as the norm,” she told ABC News.

Aquino estimates that for basic gender reassignment surgery, which might involve a vaginoplasty or genital reconstruction, it will cost a patient around $20,000, and that’s “on the low end.”

“People who don’t have her notoriety or her financial means ... they have a terrible time of it,” Aquino said. “And they don’t get the exposure that they deserve.”

For people looking to do more than just gender reassignment surgery, and want to have facial surgery or breast augmentation surgery as well, the procedures can quickly add up to around the $50,000 or $60,000 range, Aquino said, noting that the estimate doesn't even include lodging, transportation or taking time off from work.

Lindsay Deaton, a transgender activist from Cincinnati, said she needs regular medical check-ups since hormones put her more at risk for stroke and blood clots. She transitioned two years ago at age 57.

“The tangible medical needs are truly primary for the transgender community,” said Deaton, who noted it’s important to remember her medical costs related to her transitioning will continue for the rest of her life. “The regular medical need will never go away.”

Aquino also said there remains a persistent black market for hormones, since without insurance they can run around $500 per month. Aquino said sometimes if a condition is classified as an endocrine disorder the insurance will cover it and lower out-of-pocket costs to approximately $15 per month.

Aquino said her group is seeing more private employers offer to cover gender reassignment surgery, but for the vast majority of transgender people it remains an out-of-pocket cost.

She said transgender women can face intense discrimination from family, work colleagues and others that make it almost impossible to have the support necessary to successfully transition.

“I call it complete social exile. It’s quite acute and quite pervasive. ... It’s being able to go to the grocery store and not being harassed,” Aquino said. “I think people don’t actually know that. That’s why it’s still very hard.”

After the City and County of San Francisco agreed to cover procedures for gender transitions in 2001, the total costs per claimant averaged approximately $25,542 during the first five years, according to a report issued by the Human Rights Campaign.

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