Ranges of transition costs: Therapy

Therapy is where you should start. It will help you determine how important this is to you. It will also help you sort out your emotions. Most people have fantasies or misconceptions about transition. The key to all of this is feeling good about yourself. You are going to take a lot of blows to your self-esteem as you transition. You must have a way to deal with these. Starting a therapists relationship early will also make it easier to get hormones and an SRS letter when you are ready.

See my page on choosing a therapist for more information.

The costs below reflect two important things: three years of cumulative costs, and insurance coverage in all but example 5. Most people are able to get therapy covered on insurance, even if their policy forbids it for TS therapy. Just have it put down as "depression."

Therapist #1: In order to get SRS, you will need two therapists. Most people have a primary therapist they begin seeing at the onset, and use the second therapist as a second opinion. Your first therapist will be the one to OK you for hormones if your physician requires a letter. Since some people need to travel to find a good therapist, don't forget to estimate that into your costs if necessary.

Therapist #2: Most people wait to see their second therapist until they are full-time, and approaching SRS.

Couples therapy: If you plan to stay in a relationship, you may need to have some couples therapy to work through the issues. If you have children and think they may need counseling, you should also think about budgeting for this.

Coming out travel: If you suspect you will need to make a trip to tell a friend or relative about your transition in person, you should consider setting aside money for this.

Do not base your own budget on these examples!

• Example 1 is the minimum anyone has reported for the category-- best-case.
• Examples 2, 3 and 4 represent standard ranges, with Example 3 as my attempt to show the most typical.
• Example 5 is the maximum anyone has reported for the category-- worst-case.

• ^[1] Read all notes in purple for explanation of estimates.
• ^[2] Notes in red contain very important information that will significantly affect costs and budgeting.
• The "Your estimate" column will be filled in as part of Exercise 7.

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• ^[1] Therapists usually charge an hourly rate between $50 and $200. Therapists may require you to come once a week, once a month, etc., so costs will be affected by frequency of sessions. Some therapists also charge a one-time fee for SRS letters (both mine charged $250 for the letter). Many people whose insurance does not cover transition-related services have their therapy classified under "depression" to get it covered. You will need letters from two therapists for SRS from most surgeons. Women with SRS covered by insurance may also have to appear before an insurance company committee or physician for surgical approval. You should consider planning on continuing therapy after transition.
• ^[2] If you will need to make a special trip to tell someone in person you're TS, you should budget that in.
• ^[3] Assuming $300 annual insurance deductible for three years, submitted as "depression.". Second opinion has already met deductible.
• ^[4] Assuming $300 annual insurance deductible for three years, submitted as "depression."
• ^[5] Assuming uninsured $100 monthly sessions for three years, plus $250 for SRS letter.
• ^[6] Assuming second therapist not covered by insurance, but only requires one session for second opinion.
• ^[7] Assuming second therapist not covered by insurance and requires several sessions.