Direct Financial costs of mtf transitioning

[Swedishgirl96]

Very interesting to read your perspectives on things. I have no experience of the American model. I have just heard that there is some hot political debate going on between your two partys. And I don't want to get involved in American party politics.

But it sounds like the system is quite beneficial for some and tougher for others.

In order to tell my financial cost for transition I have to explain how our medical system works in Sweden.

Here all health care are government founded. The health care is provided by the government though there are some private clinics and a private hospital, that I know of. But they have a deal with the government so they function in the same way as the government runed and they cost the same.

There is a principal fee when you make any health care visit, it varies from around 11 to around 44 dollars.
There is a lot of exceptions from this fee though.

There is a roof (high costs protection) for ones medical costs in a 12 month period. The roof is around 122 dollars. When you hit that roof, you are free of charge for a 12 month period.

Then we have medicines. There is a high cost protection here as well. But here its more complex and works like a discount stair. The government subsides prescription drugs until you reach a roof. Then its free of charge for a 12 month period. The higher your costs are the higher the percentage of the government subsidies. The roof for prescription medicines are around 256 dollars.

Both of these system works automatically through computers. So I do not have to do anything to make sure things work and it works very well. We are also able to get our travels to and home from medical treatment paid by the state. Of curse they just pay for the cheapest possible way of travel. This system is not automatic and I have not bothered to use it. I don't feel that I need it and I see no need of robbing the state of money.

So I have reached the roof for health care since a while ago so I have paid around 122 dollars for this.
I have paid 220 dollars for prescript medicines so far.
I have prescription for Triptorelin (gnrh analog), Estrogen and Sertraline (antidepressant).

A shot of triptorelin costs 299 dollars but in the drugstore I just had to pay 125 for it, the government subsidized the rest. After I have bought the injection a nurse helt me to inject it at my local health center, free of charge.
I pay around 68 dollars for my estrogen patches.
And last around 20 dollars for Sertraline.

So around 342 dollars is what I have paid so far.

What do I get?
So far I have done fertility-preserving treatment (freezing), I have started hrt and laser hair removal.
I will have a trach shave surgery this spring and meet a speech therapist in the end of February.
Genital surgery are still a bit away in the future.

In order to revive government funded transition treatment in Sweden you need a diagnosis. Because of that before you are able to begin treatment you need to be examined by a medical team at one of our gender identity clinics. That medical assessment can take between 4 months up to a couple of years depending on each case. Mine took around 4 months.
The waiting lines for ones first appointment are absurdly long though. Some clinics even have 16 months or more before they are able to receive you. I had to wait around one year.

We of curse have problems in our system as well but I have to confess that it feels quite well to not have to worry about financial facts when it comes to my transition. At lest not so far. I have had some thoughts about FFS witch they don't provide in Sweden or making my GCS abroad. But I'm not sure yet.

Hugs!

[Linde]

Another example of the US system.  I am just back from a trans gender specific endocrinologist, the star in that field in South West Florida.  he does not accept my insurances, and i had to pay out of pocket.  I was there for about an hour and had to pay $402.00.  Now I have to try to convince my insurance to pay me for a part of that bill. (probably 60% of it).  That means, if you have a low income, and want to get transgender (or other specialized) services, you will not get them, because you do not have the money available.

That's what is wrong with the US system, if you have money, you get top class health services (in my opinion, the best in the world - I worked in the system for 36 years), if you don't, you have to see how you limp along!

Obama wanted a national health care system the way most European countries have, but the opposing party blocked everything, and is still trying to derail the bits that are left!

[NatalieRene]

Very interesting to read your perspectives on things. I have no experience of the American model. I have just heard that there is some hot political debate going on between your two partys. And I don't want to get involved in American party politics.

But it sounds like the system is quite beneficial for some and tougher for others.

In order to tell my financial cost for transition I have to explain how our medical system works in Sweden.

Here all health care are government founded. The health care is provided by the government though there are some private clinics and a private hospital, that I know of. But they have a deal with the government so they function in the same way as the government runed and they cost the same.

There is a principal fee when you make any health care visit, it varies from around 11 to around 44 dollars.
There is a lot of exceptions from this fee though.

There is a roof (high costs protection) for ones medical costs in a 12 month period. The roof is around 122 dollars. When you hit that roof, you are free of charge for a 12 month period.

Then we have medicines. There is a high cost protection here as well. But here its more complex and works like a discount stair. The government subsides prescription drugs until you reach a roof. Then its free of charge for a 12 month period. The higher your costs are the higher the percentage of the government subsidies. The roof for prescription medicines are around 256 dollars.

Both of these system works automatically through computers. So I do not have to do anything to make sure things work and it works very well. We are also able to get our travels to and home from medical treatment paid by the state. Of curse they just pay for the cheapest possible way of travel. This system is not automatic and I have not bothered to use it. I don't feel that I need it and I see no need of robbing the state of money.

So I have reached the roof for health care since a while ago so I have paid around 122 dollars for this.
I have paid 220 dollars for prescript medicines so far.
I have prescription for Triptorelin (gnrh analog), Estrogen and Sertraline (antidepressant).

A shot of triptorelin costs 299 dollars but in the drugstore I just had to pay 125 for it, the government subsidized the rest. After I have bought the injection a nurse helt me to inject it at my local health center, free of charge.
I pay around 68 dollars for my estrogen patches.
And last around 20 dollars for Sertraline.

So around 342 dollars is what I have paid so far.

What do I get?
So far I have done fertility-preserving treatment (freezing), I have started hrt and laser hair removal.
I will have a trach shave surgery this spring and meet a speech therapist in the end of February.
Genital surgery are still a bit away in the future.

In order to revive government funded transition treatment in Sweden you need a diagnosis. Because of that before you are able to begin treatment you need to be examined by a medical team at one of our gender identity clinics. That medical assessment can take between 4 months up to a couple of years depending on each case. Mine took around 4 months.
The waiting lines for ones first appointment are absurdly long though. Some clinics even have 16 months or more before they are able to receive you. I had to wait around one year.

We of curse have problems in our system as well but I have to confess that it feels quite well to not have to worry about financial facts when it comes to my transition. At lest not so far. I have had some thoughts about FFS witch they don't provide in Sweden or making my GCS abroad. But I'm not sure yet.

Hugs!

Time is the fire in which we burn. I am not detracting from your medical system but in all things anywhere a balance between quality, speed and how fast it is has to be struck. In your case it sounds like inexpensive and high quality was the choice at the expense of time.

In my case it was quality and as little time as possible at the cost of working a second job (programming in DC, Ashburn and remotely for roughly six months) in order to cover the expenses out of pocket without incurring debt.

The American system is very much broken but at the same time if you have the money there is little to no waiting.

[Swedishgirl96]

Another example of the US system.  I am just back from a trans gender specific endocrinologist, the star in that field in South West Florida.  he does not accept my insurances, and i had to pay out of pocket.  I was there for about an hour and had to pay $402.00.  Now I have to try to convince my insurance to pay me for a part of that bill. (probably 60% of it).  That means, if you have a low income, and want to get transgender (or other specialized) services, you will not get them, because you do not have the money available.

That's what is wrong with the US system, if you have money, you get top class health services (in my opinion, the best in the world - I worked in the system for 36 years), if you don't, you have to see how you limp along!

Obama wanted a national health care system the way most European countries have, but the opposing party blocked everything, and is still trying to derail the bits that are left!

I'm very impressed by the speed and quality of the American system. Here in Sweden the ordinary person on the street thinks that the American health system is an evil system. That one should not be able to make money on health care. But since I also know about the big big problems in our system I must admit I'm a bit curious on alternative ways. I think we at least should consider allowing private options to take som load of our government system. The idea about equality is very strong here. It's rooted deep.

But since you have the kind of system that you have, I guess most people must profit from it. But, hypothetically, would your system refuse health care to anyone if they would be so sick they may die and not have an insurance?

Time is the fire in which we burn. I am not detracting from your medical system but in all things anywhere a balance between quality, speed and how fast it is has to be struck. In your case it sounds like inexpensive and high quality was the choice at the expense of time.

In my case it was quality and as little time as possible at the cost of working a second job (programming in DC, Ashburn and remotely for roughly six months) in order to cover the expenses out of pocket without incurring debt.

The American system is very much broken but at the same time if you have the money there is little to no waiting.

I agree with you. Our system is practical free, the costs are just symbolic sums. I would say that the quality is actually very good, the standard is usually quite high. The government likes to burn money on quality medicines and stuff. The doctors and nurses treat you as a patient very well. They have a lot of understanding about trans issues. But the waiting time is absurd.

The waiting time have gone up quite dramatically the last 5-7 years. Actually extremely high. Every year the number of people who seeks gender affirming care have dubbled since 2013. And the health care budget was not prepared for this and is still lagging. I don't know if they will be able to get things reasonable again. The Swedish health care system is under severe pressure at the moment. But that's Swedish politics and that is quite different from US.

[luckygirl]

sounds like the system is quite beneficial for some and tougher for others

there is nothing egalitarian about anything in the United States. It is all about the $$$$.  Course, if you have                                $$$$, this is a wonderland.

[NatalieRene]

there is nothing egalitarian about anything in the United States. It is all about the $$$$.  Course, if you have                                $$$$, this is a wonderland.

Being equal doesn't mean everyone has the same things. I think you are confusing the currency of trade in the realm for rights of the citizens. I also think we should avoid politics on this site.

[luckygirl]

Being equal doesn't mean everyone has the same things. I think you are confusing the currency of trade in the realm for rights of the citizens. I also think we should avoid politics on this site.

rights of the citizens? you're kidding right? there is a monster difference between dejure and defacto laws and their implementation.  That was an opinion, By the by. There was nothing political mentioned there. I won't comment again on this subject because I don't like hijacking threads.

[JudiBlueEyes]

@Jenny1969  @Swedishgirl96

You both wrote that your care has been or will be free.  Nothing is free.  You served in the military and earned those benefits Jenny.  And I understand that healthcare is paid for in Sweden because the taxes are high enough to cover it.   

We do seem to have a wonky system of healthcare in the US, so we're left to work with what we have.   

[ChrissyRyan]

There seems to be a lot of costs for most people, especially so if one completes surgeries.


Chrissy

[Lynne]

There seems to be a lot of costs for most people, especially so if one completes surgeries.

Chrissy

Yes... and it's sad, that because of the costs a lot of people have no access to these surgeries.

[ChrissyRyan]

The mtf HRT medicine itself may be the least expensive item, not counting the associated physician and lab fees.

If someone knows, what is the cost for the twice a week E patches for 30 or 90 days?
Then the costs for the E generic one a day tablets for 30 days or 90 days?

For a 30 day box of E patches to be used for 82 hours (1/2 week) each, do they provide eight or nine of these patches in a 30 day supply container?  My guess is that a 30 day supply is actually a 28 day supply.  So you would really need about 13 monthly boxes each year, not twelve.

I am not putting doses in above medicine lists because I think we are not to mention doses.

Chrissy

[Maid Marion]

Often, the cost of medicine is a function of the number of doses.  This is why people will cut pills in half, to cut the effective out of pocket cost of a medicine in half.  Or, put another way, the 40 mg pills cost no more than the 20 mg pills when covered by insurance.

[JLT1]

Hi,

I transitioned four years ago.  I had FFS, GCS, BA, electrolysis, hair transplant..  Then add in psych, endo, physicals, hrt... With great insurance, just over $28,000. 

Jen

[Jenny1969]

@Jenny1969  @Swedishgirl96

You both wrote that your care has been or will be free.  Nothing is free.  You served in the military and earned those benefits Jenny.  And I understand that healthcare is paid for in Sweden because the taxes are high enough to cover it.   

We do seem to have a wonky system of healthcare in the US, so we're left to work with what we have.   

@Judi

Yes you are correct.   I should have worded that a little better. 

[Linde]

I'm very impressed by the speed and quality of the American system. Here in Sweden the ordinary person on the street thinks that the American health system is an evil system. That one should not be able to make money on health care.

So what do those Swedish people think a system, can obtain qualified workers, if they do not get paid well?
I wen tot the university for about 10 years, an did earn hardly any money during this time!  You bet that I wanted to make money once I was out working in health care, and I wanted to pay into a pension fund, too.  This means, I wanted to make a decent profit on my education and my work.  And I paid back by making some important inventions in the field (anybody, who undergoes major surgery, globally, will have it done by utilizing some developments I made in this field).
Which means, those people who think one should not make a profit in health care, are very willing to benefit from my work, but are not willing to compensate me for this?

[luckygirl]

So what do those Swedish people think a system, can obtain qualified workers, if they do not get paid well?
I wen tot the university for about 10 years, an did earn hardly any money during this time!  You bet that I wanted to make money once I was out working in health care, and I wanted to pay into a pension fund, too.  This means, I wanted to make a decent profit on my education and my work.  And I paid back by making some important inventions in the field (anybody, who undergoes major surgery, globally, will have it done by utilizing some developments I made in this field).
Which means, those people who think one should not make a profit in health care, are very willing to benefit from my work, but are not willing to compensate me for this?

I don't think anyone wouldn't want Doctor's and Nurses and PA,s and LNs or LVNs to be compensated well for their hard work. Insurance Companies? Pharmaceutical Companies? Some Hospitals? Well that's another kettle of fish and actually driving quality people from the field. Stockholder's in Insurance companies shouldn't decide who gets what treatment and who lives or dies. I could go on here ad infinitum, but my point is not that hard workers in the field shouldn't be paid well. When I transitioned, my Insurance Company had no interest in helping and there was a specific  point of noting that no gender change procedures would be sponsored. The U.S. system in my opinion, borders on the criminal.

[Linde]

The U.S. system in my opinion, borders on the criminal.

Believe me, most providers feel the same as you do, it is frustrating to have the absolutely best solution available, but being not allowed to apply it, because of cost restrictions by the insurance companies.
Having lived about 1/2 of my life in Europe, I would take their system at any time (France seems to have the best system in place).  I am not that much for a single payer system, because that removes the incentives for providers and creates very long waiting times.  There is no reason to have a health competition between providers, but keep the cost for services under tight control. And we should have a non profit insurance system in competition with a for profit one (like in Germany), and that seems to function pretty well!

[Swedishgirl96]

And I understand that healthcare is paid for in Sweden because the taxes are high enough to cover it.   

Absolutely. That is how it works. We pay high taxes. A lot more than you do in the US.

So what do those Swedish people think a system, can obtain qualified workers, if they do not get paid well?
I wen tot the university for about 10 years, an did earn hardly any money during this time!  You bet that I wanted to make money once I was out working in health care, and I wanted to pay into a pension fund, too.  This means, I wanted to make a decent profit on my education and my work.  And I paid back by making some important inventions in the field (anybody, who undergoes major surgery, globally, will have it done by utilizing some developments I made in this field).
Which means, those people who think one should not make a profit in health care, are very willing to benefit from my work, but are not willing to compensate me for this?

I have no problem with what you are saying. I understand your point of view and I agree with you. You should be able to make money out of hard work. But Sweden is a country were people don't like hierarchies, we prefer a flat organization. And Sweden is govern by socialist ideas. That's just the way things are here. It part of the consensus, no big debate at all.
I think that the average swede would see no problem with you having an high income but they would want you to "take responsibility" and pay high taxes. People here se no conflict between getting a good education to make a lot of money and then paying taxes for it.
But that's politics.

[NatalieRene]

Absolutely. That is how it works. We pay high taxes. A lot more than you do in the US.
I have no problem with what you are saying. I understand your point of view and I agree with you. You should be able to make money out of hard work. But Sweden is a country were people don't like hierarchies, we prefer a flat organization. And Sweden is govern by socialist ideas. That's just the way things are here. It part of the consensus, no big debate at all.
I think that the average swede would see no problem with you having an high income but they would want you to "take responsibility" and pay high taxes. People here se no conflict between getting a good education to make a lot of money and then paying taxes for it.
But that's politics.

As long as the return from the taxes is there it is worth it.

[EllenJ2003]

Total cost for me up through my SRS?  Hmmm, it's been a while (I had my SRS back in 2003).  Lemme think:

1.  Electrolysis (laser was just coming on the scene back when I started transitioning in late 1998) - around $35,000 (I had very little body hair, but a ridiculous amount of facial hair [I used to shave myself raw at 4:30 am for work, and I'd have 5 o-clock shadow by 9 am - yeesh!).

2.  Meds  & doctor's visits (luckily once I came out in work in mid 1999, my health insurance covered meds and doctor's visits) = about $2000

3.  Clothes - about $2000 (once I got my wardrobe settled to my satisfaction, I tried to go easy on buying clothes [to have addtional money towards SRS]).

4.  SRS, Rhinoplasty, and Trach. Shave - $14,000 (I was one of Suporn's last "lower priced surgeries" - in 2004, he raised rates by like 20 or 30%).  F.Y.I. - as was typical back then, my employer provided health insurance did NOT cover the cost of this item (I remember reading our health insurance policy and it had a specific rider in it saying that "sexual transformation surgery" would NOT be covered [which was confirmed by that bastard of an HR director I had to deal with at the time -  he was the one who gave me nothing but grief with regards to bathroom issues]).

Total cost out of pocket for me, including SRS - about $53,000.