well so firstly it sounds like you have insurance, which means you CAN find doctors who will take it most likely, sure they may not be the best surgeons in the world but they are good. Mine wasn't done by one of the leading surgeons in the world, but he is a very good one and he takes medicare and the like. I used my employers insurance, but the facility and doctors took the insurance for the other as well. You will have copays and your out of pocket you have to do and all that but you can find things that will allow you to do it if you work at it enough. If these things are purely cosmetic (ie facial surgeries) well the fact is that largely for many that is only done because of interpersonal reasons that frankly they usually weren't needed to begin with. You have it in yourself to feel you are fine. There are women who have looks in all varieties, so if you aren't passing it is likely because you haven't put time into the subtleties and are so hooked on the "I don't look female enough" that you are automatically setting off peoples suspicions. So it really depends on the surgery you are going for and why you are trying for it. If you are going for facial stuff. I would argue that therapy is the better option, if you are going for breasts, hormones will grow some and there is forms to fill in the rest if needed until you can afford it. and if it is say bottom surgery, then look for doctors who do it and will take your insurance. you may find that going on a flight may be cheaper than trying to go to someone close if needed. that's the only real advice I can give you.

i am working on getting my bottom surgery which will make me complete
i do have private insurance but they wont take it which they want the payment up front. the hospitals are covered under my insurance, but coming up with the full amount is up front as if i have 26k in my account

I have done more research and i have spent hours on the phone with my healthcare provider telling me that i have met my deductible for the year and i have a phone consultation on May 19th. I don't know what they will be asking me but i do hope that i can get it done by the end of the year so that i don't have to do the deductible again, right now they will pay 80% leaving me with the balance of 5k. but i will see as time passes. As for the Jim Collins Foundation i am not a candidate for the program as i do have insurance to pay some of the surgery, I do know that the one doctor i will be speaking to will be from Temple University Hospital in Philadelphia. The other one is at Jefferson University in the same city but they want me to see a urologists do you know anything about that??? i spoke to others that have had the procedure done they said they didn't see one ? that is a good question,. but for now i am going to wait and see as i have a whole list of questions to ask'

okay so your consult is generally just going to be a gathering session, they are going to talk to you, find out why you want it, what type of procedure you are going to go for, all the possible issues associated with the procedures, risks and so on. then they are going to want your letters from mental health professionals and all that. They are likely going to tell you that you need to have electrolysis done and be 80% clear by surgery date (not gonna lie, that part sucks) and so on. As to why you would have to see a urologist, It is likely precautionary. In my case my surgery was performed BY a urologist, so I already had it done. What I am going to tell you is that odds are they are likely going to have you see one before and after to make sure all the plumbing fixtures are working the way they are supposed to. So overall its not a bad thing.

Financially im gonna also let you know that nearly 30K is just surgery and NOT hospitalization. You will have some additional medical bills beyond that for hospitalization after. Ill give you a run down of how my whole mess went.

In 2018 I went to see my surgeon who was going to do my operation. I already had all my letters and all my other checks done. So it was a quick check of the hardware and see what he was going to do, discuss all the ins and outs of the types of procedure that could be done, whether I wanted full depth or zero (I did full), and so on. then I had a year wait (it was the height of the ACA so all the people on medicare had gotten in 6 months before me and this facility took medicare). In that time I had to go through electrolysis which not all require but it is universally recommended. My surgeon required it. That took me nearly a complete year because I have notoriously stubborn hair and had to fight with my insurance to cover it. So it was weekly appointments for that for 1-3 hours with the last week spending 4-6 hrs. anyhow, a week or two before the surgery I had my presurgical screening, which was an independent doctor checking my complete physical status and checking over my documentation, my reasoning making sure I was in the right mind to say yes I wanted to do what I was and make sure I was healthy enough to survive the surgery. couple days before the surgery I had to stop eating and go on a liquid diet, so my guts were clear of everything. Day of the surgery, I had to be at the hospital at like 6am, I went into surgery at about 7AM and I wasn't wheeled out till somewhere around 6PM or atleast that's when I made it to my room. From there I spent 5 full days in the hospital. Day 1-3 you have bandages that feel nothing short of being iron undies, they are SUPER uncomfy. Even with my really really high pain tolerance, I was still taking the pain killers though not as frequent as most. so expect that first few days to suck really bad. You wont be allowed to get up or even really move during the time in the hospital. sometime in that 3rd day they remove the iron undies which is the outer dressings, at this point things are pretty livable but you still aren't allowed to move. after about 5 days in bed, they are going to fully undress the wounds and check you over and you will be able to get up for the first time. They are going to tell you to take it slow... LISTEN TO THEM. 5 days may not seem like a long time but you are going to get dizzy just sitting up completely let alone putting your legs on the floor and so on. You wont be up walking much at this point. From there youre going to likely be on bed rest for 6-12 weeks. orders are stay down as much as possible. youll have lots of visits to the doctor to inspect healing and so on. Youll also have to start dialating if you do full depth. This is uncomfy but not terrible. Buy large bottles of water based high quality lube now. youll do this 3 times a day and burn through it fast. From there you wont have a whole hell of a lot of feeling or anything for about 90 days to 120 days, or I should say no feeling that is that pleasant. after about 120 days you should be able to struggle out some joy from things. but full healing is about a year process. Youll dialate 3 times a day for probably 3 months during that time you will work up through the sizes till you are at the largest size, from there youll start trimming back to 2 times a day every other day being 3 then 2 every day, so on down to about 1-2 times a week. (I am a year on june 17th and I am right now at 2 times a week). Financially, the surgery for me was about 37K, however my total medical bills in their entirety was almost $120k because that 5 days in the hospital bed was another $90K. I am telling you this because I want you to understand that there may be more to it. In my case my insurance out of pocket was met, so end of the day I only paid $5000 for everything. You may want to do some investigating. Mine insurance was 80% to a $5000 out of pocket cap then it was 100% for in network. Some people only spend a couple days in the hospital and then find like a local hospice or something that might be cheaper, but I mean you aren't going to be able to do this without someone there to care for you period. even that first 60 days after I was released, I needed a good deal of help. Your consult is going to cover most of this and should have you pretty well run down with the details.

that got really long so I wanted to just hit send rather than lose it all. but yeah plan on some hospitalization and the healing is VERY SLOW and anything but easy. I had a minor complication with my surgery and had a pretty extensive op. Mine involved skin grafting and such, so I not only had to worry about the primary site but two additional graft points and their care and ended up with granulated tissue which has required treatment with silver nitrate on a regular basis. At a almost a year, I am pretty well all healed except pin head sized spots of granulated tissue which should be gone soon. I also had some deadness in my left hip as a result of one of the grafts and the nerves on my hip are just now starting to reconnect. Recommendations, make sure you plan for the hospital expenses. If possible have someone there to help you shower and cook for you and so on, if you cant, expect to eat lots of very simple foods like pb and J or other shelf stable ready to eat things you can have at bedside. While you will be able to sit up, its going to hurt. If after a month or so you HAVE to sit, get at least a hemorrhoids pillow. If you can find one, a better option is look on amazon for a toilet seat cover. They have these really nice 2 inch thick foam covers that are U shaped that are WAY easier to sit on than the other pillow. Lastly... get a wand style massager, not a vibrator thing, I mean one of those big old bulky massagers. Your nerves are going to flip the hell out like nothing you have ever felt. That massager after you have pretty well healed up and our scabs are gone is going to do wonders for making your scars more mobile and less hard as well as you can let it get the nerves to figure out what is going on. Again this isn't to scare you or anything it is to prepare you. The surgery is survivable and I will say for me it was 100% worth it. Healing sucks and the dialation gets tiresome, being in pain for so long and out of commission sucks, having to have help for simple things like getting on and off the toilet sucks, not being able to bend over to dress yourself, I mean it is not fun in any way. But if you know its what you want and you know it isn't going to change any aspect of your life other than your body and your own ability to live in your body, then it can deff be worth the work. Hope this is of some help.

thanks for all the info, i have spoken to my health care provider and they will cover 80% of the all the procedures, since I am not eligible for any help from any foundations like the Jim Collins due to the fact i have private insurance. The doctor that i have found is in my network and so is the hospital that the procedure will be done. I will be seeing thier urologists and that is covered as well, i know that i will have to pay the remaining 20% that won't be covered at least I will be making monthly payments. I am just glad that i am a candidate for the procedure and they can schedule me before the years end, i just have to keep on my therapist to send out the letter. i still need 2 letters, even though i think it is stupid but i made myself adimit that i wasn't going to back out of it or regret it. this will make me happy

You know I am kinda on the fence on the letter thing honestly. But I think I lean more to the side of agreeing with it. I 100% agree with requiring one at least. I think that it is valid for something as extreme as what we have to go through to make sure that there are plenty of checks and balances in place to ensure that there isn't something else going on and we aren't just bandaging something that is more a symptom rather than a cause. So the idea of the therapy I am completely down with. The single letter is a bit sketchy for me because I have met some really bad therapists that not only will write them without even really bothering to see the patient but even seen a few that will press a patient to do it even though it isn't right. So that second letter from an unassociated professional is nice, Now im not saying that you cant find 2 that would just write it and go, but it makes it a bit harder. I help colead an lgbt social group and one of the people who was coming to us was a younger person and they were going to a therapist that was all but pressing them to go through surgery and hormones and what not. Thing is, everyone could tell this person should never do that she wanted to have children (she was born female) and I am sorry but if you were born a woman and you WANT TO carry children and give birth.... you are likely not a female to male trans person. You may fall somewhere on the spectrum but I really don't believe that going through the being sterilized and all is the right move. but this therapist was pressing for them to go. So I have seen it happen. Side not happily this person decided to go a much different direction, so yeah. I know a number of trans who want kids, but the second you say that it kind precludes the idea of surgery unless you are going to do so with medical help, ie freeze sperm or what not. anyhow, yeah so I do lean towards agreeing with the 2 letter thing because in situations like that even if one signs it, another might be like... well wait a second here. lets really talk about this. The second letter you don't have to worry to much about though. The first one is the harder of the two, I recommend getting a certified original for yourself to keep locked away for legal reasons (birth cert changes and such). The second is usually complete in one or two sessions. They will talk to you bout some things have some checks and balances to look at and as long as they see certain things checked off its pretty fast. It isn't like getting the first. I do wish you luck in the surgery. Its pretty strenuous on the body and mind so be ready for that. For me I had a really hard time with the dialation because it was painful at first and the dread of having to do it 3 times a day, it becomes such a major part of your day and you cannot miss the sessions or say oh. well I cant do this in the afternoon so I will just put it off till 4 and then still do the other that like 8... if you do that one at 4 sucks really bad and is way uncomfy. (8 hrs between them tops). This makes work complex. I was doing a thing where I was doing one before work, then I went to work and when I got home immediately doing one which that one was a bit rough, and then right before bed at about 10pm. But you're entire live feels like it revolves around it. and then the whole thing of having to ask someone to help dress you and things. they were really rough on me. Some people will have an easier time with that, but I am VERY independent, so not being able to shower myself, or dress myself was really rough. Things like that make you want to rush and push yourself and that is a serious mistake with this or any major op. So yeah, wanted you to know those things are coming so you can prepare. When I went through it I knew about them but was like oh... 5 days in bed, ill be fine... and yeah I almost blacked out 3 or 4 times the first time I tried to get up. I thought, oh well I should be able to bend over and all, its just gonna hurt to sit right? WRONG, those stitches tug every time you move and they make sure to remind you they are there often :P so yeah. be prepared to take your time once you get there. its going to be a mad dash the next 6 months to that line, its going to feel insane, and then you are just going to stop. take your time, expect to be down for 2 months min. Expect to be 3-6 months out before you can orgasm, sex is out for about 6 anyhow, expect things to be difficult for about a year physically. Expect to relearn a lot of things. something as simple as say... going to the bathroom and having to do both. I remember sitting there thinking... okay... which do I deal with first. I know front to back, but do I wipe pee back to my butt or do I try to deal with that first? how the hell does this work. Its an interesting learning curve. Learning that point where if you haven't gone to take a pee before your gonna pee yourself.... you just lost some hose, that timeline is WAY SHORTER :P simple stupid things like that are going to be fun for a good 6 months. I am glad you got the financial aspect covered though, when you listed the amount I got a bit worried cause I was shocked when I saw how much more it was and realized the bed wasn't included.