Thank you for the clarification on that. That is actually about the U.S. price for that procedure for MtF, but it does show a common, international fault of governments world wide. I worked for the US State Of California and a single simple ball point pen, which could not be the most simple due to legal specifications cost 5 times what I bought a dozen of the equally serviceable pens for for my home use. My surgery which was the simpler and less complicated scrotal graft and partial penile inversion technique and was $23K US. The FtM price you are quoting is close as well for that procedure at the highest end. Yes, badly underfunded, but still cheap compared to costs of attempted suicides and self harm hospitalizations.