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International Gender Reassignment Options

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Getting gender reassignment surgery, while becoming easier for some trans women, either through the liberalization of corporate health insurance, expansion of Medicare or court rulings, is still very expensive, as can be attested to by talking to any group of transgender women, who often have to save their pennies towards that “some day” when they can finally afford it.

Many of the more enlightened countries of the world are way ahead of the United States and provide gender reassignment surgery to their citizens as part of their nation’s healthcare plans, like the UK and the rest of Western Europe. While the United States is slowly moving towards providing these procedures to those who have insurance or government-provided care, for most, the fees are a significant barrier, costing $50,000 and up.

Thailand has a long tradition of trans acceptance. There is widespread acceptance of katoey or ladyboy sex workers who peddle themselves openly in urban environments, however conceptually demeaning we might find it here in the west. This acceptance of ladyboys has resulted in Thailand becoming the biggest gender reassignment center in the world, helped no doubt by the relatively low cost, widely quoted in the vicinity of $5,000.

While arguably Thailand’s permissive culture has allowed for a vibrant trans culture and many gender-reassignment surgeries, Iran holds the #2 spot for transitions for almost exactly the opposite reason. Homosexuality is punishable by death in Iran, though as the Koran fails to mention sex changes in its text, there are no prohibitions on the procedure, according to a fatwa issued by Ayatollah Khomeini in 1989. Many gay men and lesbian women undergo the reassignment surgeries in order to be able to be with the gender of their choosing, by sacrificing theirs, though that price doesn’t come without regret, and once changed, does not mean that they don’t face social stigma, just that they don’t face the death penalty for acting on their romantic impulses. Citizens split the costs of their gender reassignment with the government, resulting in roughly a $2,500 cost to the recipient, though many Iranians who can afford to travel, go to Thailand to have their procedures performed.

Serbia is another surprising center for gender reassignment surgeries, and the low cost and relatively high standards of care have trans women from other countries flocking to this culturally conservative country, primarily from other Eastern European countries that don’t have the means or the desire to have these procedures performed. Cost is alway a factor and gender reassignment surgery in Serbia running around $10,000.

While slow progress towards coverage in the United States continues, those who have saved a portion of the funds can get it done internationally, though there are attendant risks, not only with the procedure itself, but also with the risks of a complication occurring while you are in a foreign land. So if you are going to explore this option, do extensive research first.

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