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Keeping Up With Cait: The Cost of Being Transgender

It takes big money to look as good as Caitlyn Jenner. We break down the hefty price of becoming a woman
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Getting All Hormonal
Hormone Replacement Therapy (HRT) is the first step in creating more feminine features. Taking estrogen hormones or androgen blockers can increase bust size, raise voice pitch and prevent facial hair from growing.

Transgender women typically see results within a few months, with results being finalized (aka, this is as feminine as hormones can make you) after about a year and a half.

Cost: Hormones are typically covered by most insurance policies, but transgender women will need to take them every day, indefinitely. Adding in the cost of doctor's visits and blood work to monitor hormones, you can expect to pay around $200 to $500 a year if you're covered. If you're not covered through your job or you're unemployed, you're looking at an annual cost of anywhere from $650 to $1,000, which takes doctor's visits, blood work and prescription cost into consideration. Hanson advises looking into getting care through the Affordable Care Act, which does cover HRT.

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Zapping Butt Hair and the 5 O'Clock Shadow
Even with HRT, not all unwanted hair goes away. Many transgender women still experience the five o'clock shadow and body hair. To get rid of it, they usually turn to electrolysis.

Depending on how much hair you're trying to remove, costs vary. At the very least, transgender women typically remove facial hair, according to Sabrena Smith, owner of Sabrena Smith Electrolysis in Hollywood, CA. Smith says that after being on HRT, most of her clients find that their arm and torso hair stops growing in. For those who don't experience less hair growth, shaving is usually the norm.

However, hair growing on places like the back is hard to take care of, says Monica Prata, a feminine image consultant and owner of Nouveau She, a service that helps transgender women with the transition process. She has some clients who have spent around $40,000 on hair removal via electrolysis. It's also a painstakingly long process -- complete removal of a beard for someone not on HRT can be around 200 hours -- "you're zapping hair by hair," says Prata.

Some of Prata's clients turn to laser hair removal, which is ideal for someone with lighter skin and dark hair. It's less expensive and less painful, but it does require upkeep for the rest of your life (nope, it's not permanent), and it won't work on grey or light hair.

Cost: For just the face, Smith says most pay between $10,000 and $20,000, though it can cost less once HRT kicks in and the body stops producing as much hair. The full body can be up to $60,000 and take several years, according to Smith.

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Getting Your Head in the Game
Before most transgendered patients undergo facial, genital or body surgery, counseling is recommended -- and for a full genital and breast transformation, it's required by insurance and doctors.

Sometimes insurance covers therapy -- or a portion of it -- especially if gender dysphoria is causing depression, says Hanson. Seeing a therapist can literally pay: If you are diagnosed with gender identity disorder, you may get a deduction in medical expenses if they cost more than 10 percent of your income, says Hanson.

Cost: Anywhere from $50 to $200 per therapy session, depending on how much your insurance covers.

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Taking Your Face From Handsome to Pretty
As you might expect, facial surgery to look like a woman varies greatly from one patient to the next, says Dr. Jeffrey Spiegel, MD, Chief of the Division of Facial Plastic and Reconstructive Surgery at Boston University Medical Center. "Believe it or not, not everyone wants to look stunning," says Spiegel. Some people prefer to look androgynous.

"A transgender woman typically wants to blend in and be seen the same as every other woman," says Spiegel. Her end goal is to pass as a woman, not a transgender woman.

On average, Dr. Spigel performs about two to five facial feminization surgeries a week. This includes any of the following procedures:

-Rhinoplasty: $7,000*
-Adam's apple surgery: $5,000*
-Lip augmentation: $5,000*
-Forehead contouring: $12,000*
-Jaw and chin reshaping: $10,000*
-Cheek augmentation: $2,000-$7,000*
-Scalp advancement (a lowering of the hairline and adjustment of the eyebrows): $8,800*
-Facelift and eyelid surgery for older patients: $12,000*

The most common procedures involve the brow bone and Adam's apple, according to Dr. Gary Alter, MD, board-certified plastic surgeon and RealSelf.com contributor, who recently added Caitlyn Jenner to his patient roster.

Cost: $17,050 is the average price for facial feminization surgery, though Prata notes many of her clients spend around $30,000.

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Oh, and Two More Things
Hormone replacement therapy can only give you so much cleavage. After that, transgender women look to breast implants. Breast augmentation is considered a cosmetic aspect of the transformation, so most insurance companies do not cover it.

Cost: On average, male-to-female breast augmentation is $5,175*.

BY EMILY WOODRUFF | JUL 23, 2015 | SHARES
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