Long story short, raising a transgender youth is expensive. Whether it’s affirming your child with a social transition, addressing your child and your mental health, or later on supporting your youth or young adult with medical care, the costs quickly add up.
I purposefully chose not to dive too deep into this topic when I wrote the book Beyond Pronouns: The Essential Guide for Parents of Trans Children for two main reasons. First, I didn’t want to discourage parents from affirming and supporting their gender-diverse youth. While this can be an expensive journey, there are supports available. Also, I wanted the book to focus on that initial stage of social transition, and this blog will take a deeper look past those first 100 days.
Social Transition Costs
Socially transitioning refers to the process of publicly presenting as a gender that is different from the one assigned at birth. It involves changing one’s name, pronouns, clothing, hairstyle, and other aspects of their appearance to align with their true gender identity.
Here are some items that you as a parent or caregiver may need to purchase to support your child socially transitioning:
Clothing, hair care and grooming products, makeup, and voice training: Depending on the youth’s gender identity, they may need to purchase new clothing and accessories that align with their preferred gender expression. They may want to dress, groom, or speak more femininely, masculinely or androgynously.
Legal name change and ID documentation: Some youth may choose to change their name legally, which can involve court fees and other legal document expenses. You may also need to register for new ID documentation, such as a driver’s license, birth certificate or passport that reflects your child’s new name and gender marker.
Gender-affirming gear, such as packers or breast forms, are prosthetic devices that can be worn in underwear to give the appearance of a bulge. They can be made of silicone or other materials and come in various sizes and shapes. Stand-to-pee devices allow trans masculine people to stand and urinate. Gaffs are undergarments that can be worn to flatten the genitals, and binders are compression garments to help flatten the chest or create a more masculine or androgynous shape.
The cost of socially transitioning can vary greatly depending on the youth’s needs and your financial resources. Some people may need to purchase all of these items, while others may not need to buy any of them. The tricky part for a parent is to be able to budget wisely because buying everything at once may not always be possible.
Mental health support
In my blog on finding a gender-affirming psychologist, I cover that not every trans person needs a therapist. But if there is a need, the cost of seeing a psychologist can vary greatly depending on several factors, such as where you live, your insurance coverage, and the specific type of services you seek.
Generally, the cost of seeing a psychologist can range from around $75 to $250 per hour. Some psychologists charge a flat rate for each session, while others charge according to a sliding scale based on the client’s income.
It’s also worth noting that while seeing a psychologist can be expensive, it can also be a valuable investment in one’s mental health and well-being. In some cases where there is a co-occurrence of a severe mental illness, mental health is essential and not optional. Therefore, it’s important to consider the potential benefits of therapy when evaluating the costs.
Medical care
I could write an entire book on what it’s like to parent a child through a medical transition (and I’m strongly considering it), so I will briefly explain it here. Access to health care varies widely according to the country and province or state you live in. They can include hormone blockers, puberty blockers, cross hormones, hormonal replacement therapy, and surgical procedures on the face, chest, genitals and more. (Quick side note for any misinformed doubters: surgery is not performed on 8-year-olds! There are scientific international standards of care.)
Generally, medical interventions are typically covered by Canadian public healthcare and private health insurance when prescribed as part of a gender-affirming therapy plan. However, out-of-pocket costs can still be high, particularly if a person does not have insurance coverage or if their insurance has a high deductible. An American coaching client of mine shared with me just last week that for her insurer hormone blockers are billed at 8 times the rate when the child is under 18 compared to over 18! And the medication is four times the cost in the US compared to Canada. Mindblowing. Therefore, it’s advisable to check with your healthcare provider and insurance provider for specific cost information and to explore options for financial assistance if needed.
Here are a few examples of extra medical costs that your provincial health care or insurance won’t cover. Some families may need to travel to a different location for medical interventions, which can include expenses for transportation, lodging, and meals. You may need to take time off work before and after, which can result in lost wages or income. Also, you may need to arrange for childcare or eldercare during medical appointments, especially if travelling. Finally, deductibles or choosing providers who your insurance company does not cover will also result in paying out of pocket.
Self-care for parents
I am a massive advocate for a parent to prioritize their respite and self-care. I wrote a blog here with several ideas of how you can fuel your resilience to stay the course. Some ideas are reasonable, such as taking a bath or walking in nature, while others are more costly.
If you need a mentor coach for a personalized plan, a therapist to work through childhood trauma, or a couple’s therapist to avoid an even more costly divorce, please work caring for yourself into your budget for caring for your child. This is an enriching journey this raising transgender youth. The sense of pride and joy and connection and authenticity is beyond measure. But we must make it through the stressful parts first, which can only be accomplished if we put on our oxygen masks as parents.
Many of these financial realities are unavoidable and can vary according to your family’s resources and your trans youth’s needs. My best advice is to go into affirming your trans child as an informed parent or caregiver with a clear plan of action, including a workable budget.
Download the ebook Defining Transgender here to stay in touch through my newsletter and don’t forget to grab your copy of Beyond Pronouns: The Essential Guide for Parents of Trans Children.