The Cost of Transgender Health Benefits

Until recently, there has been no good information about the cost of Transgender Health Benefits (THBs.) As a result, there have been many figures cited, but all are based on assumptions.

In 2004, all that changed. A scholarly research study has been written. We now have an accurate picture of the number of sex reassignment surgeries performed each year, and their average cost.

Summary of the Research Report

The research study was undertaken from 2001 through 2008 by Mary Ann Horton, Ph.D. The goal was to measure the frequency and cost of sex reassignment surgeries, and to use this information to project the total cost of Transgender Health Benefits for the employees of large companies. This data could be used to help employers estimate what it would cost if they chose to include coverage of THBs in their employee health benefit plans.

Dr. Horton sent surveys to all surgeons who perform SRS and related surgeries on US residents, asking how many surgeries were performed in the year 2001, and how much they cost. Both Male to Female (MTF) and Female to Male (FTM) data were collected. An excellent response rate permitted the creation of high quality data about surgeries.

Approximately 1170 (all figures rounded) US transsexuals had their primary SRS in 2001. (Many went to other countries for their surgery, but the study was restricted to US resident patients, having the SRS in any country.) The average MTF cost was about $10,400, and the average FTM surgery (including top and, for those who had it, bottom surgery) was about $17,900. MTF surgeries outnumbered FTM surgeries 740 to 430, leading to an average combined cost for SRS of $12,900.

The annual cost per resident US resident for SRS was 5.3¢. Combined with the cost for hormones, doctor's office visits, and therapy, the total annual cost per resident for all THBs was 17.3¢. Of this, 8¢ or more is likely to be currently covered, and with full coverage, the employee share averages 2.6¢ therefore, the added cost to an employer to cover all four transgender health benefits is projected at 6.6¢/year/resident or less.

Read the Research Reports

Two research papers measuring the prevalence and cost were presented at the Out & Equal Workplace Summit conference on September 12, 2008, in the form of a 90 minute workshop. These papers were submitted for publication to the International Journal of Transgenderism in May of 2008.

You can view the Powerpoint from the workshop, The Cost of Transgender Health Benefits. The workshop is a good introduction to the subject, and may be followed up, if desired, by reading the papers.

The research papers are:

The Incidence and Prevalence of SRS among US Residents
This paper measures the incidence of Sex Reassignment Surgery (SRS) for US residents. It reports the number of US residents undergoing SRS in one calendar year (2001) using a survey of surgeons who offered SRS procedures. This run rate is used to calculate incidence of SRS, and to estimate prevalence. Estimates of incidence and inherent prevalence of Gender Identity Disorder (GID), mental health therapy, hormone treatments, and FTM bottom surgeries are derived.

Keywords: Transsexual Prevalence. Sex Reassignment Surgery Prevalence.

The Cost of Transgender Health Benefits .
This paper estimates cost of Transgender Health Benefits (THBs) for US residents. It reports on a 2001 survey of surgeons who offer Sex Reassignment Surgery (SRS) procedures. The survey measured the average cost for Male to Female (MTF) primary surgery (SRS) and for Female to Male (FTM) primary surgery (top surgery) in 2001. Nonsurgical costs are calculated empirically, with margins of error. Total THB cost is compared to the number of eligible US residents in the 2000 US Census to estimate the cost per resident.

Keywords: Transgender Health Benefits. THB, THB Cost, Sex Reassignment Surgery Cost, Hormone Cost, Domestic Partner Benefits Cost, Transgender Insurance Cost, Transsexual Insurance Cost, Transgender Wellness Benefits.

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