That's incredibly frustrating. No one should have to leave home to get care for themselves or their families.
I personally decided that I could not seek care internationally because, being somewhat (ok...a lot) older, I know how important it is to be able to get meaningful followup with one's surgeon if things take a nasty turn, which was indeed the case for me post BA/FFS. Being able to text/talk with my surgeon any day of the week and stop by the office has, for me, validated the decision to stick with a local surgeon rather than pursuing a big name clinic. I paid out of pocket, but my surgeon's fees were competitive to traveling abroad, especially given that I was in my own bed (chair, actually) the day of surgery. Nevertheless, the well-reputed clinics and physicians have plenty of enthusiasts on these pages. And, when it comes to GCS in March, I am getting my surgery at the Mayo Clinic, which for me is also local, covered by my insurance.
There may be other advantages to moving to a bluer state. It is easier to be trans where transfolk are more accepted. You might want to give thought to what sort of community support she can anticipate in your home area. Finding other transgender people with whom to interact is difficult in rural MN. I know there are places where it might be substantially worse. Remember that dealing with the body is only a part of the journey towards self-acceptance and coherence.
I wish you the best of luck as you try to figure out the best way to care for your kids.
