The female-to-male transition is a big step filled with emotions, questions, and, yes, worries about cost. This article breaks down the expenses associated with FTM surgery, covering everything from top surgery to voice masculinization. Learn about insurance, hidden fees, and what really drives the price. We're here to help you focus on your transformation without stressing about the finances.
Quick Overview:
- Average FTM surgery cost: $3,000-$24,900.
- Average FTM top surgery cost: $3,000 - $10,000.
- Average FTM bottom surgery cost: $20,000 - $35,000.
- Average facial masculinization surgery cost: $1,000 - $20,000.
- Average voice masculinization surgery cost: $5,000 - $15,000.
- US and UK: Generally more expensive, with FTM surgery costing from $13,000 to $138,000 on average.
- Thailand: Offers more affordable options that cost around $3,500 - $22,000.
- Turkey: The most affordable destination for FTM sex reassignment surgery, with costs usually ranging between $3,000 and $12,000.
Table of Contents
- How Much Does Female-to-Male (FTM) Surgery Cost Worldwide?
- How Much Does FTM Top Surgery Cost?
- How Much Does FTM Bottom Surgery Cost?
- How Much Does Facial Masculinization Surgery Cost?
- How Much Does Voice Masculinization Surgery Cost?
- What Factors Affect FTM Surgery Costs?
- What is Included in the Cost of FTM Gender Reassignment Surgery?
- Additional FTM Surgery Costs
- Takeaways
How Much Does Female-to-Male (FTM) Surgery Cost Worldwide?
Female-to-male (FTM) surgery, also known as transmasculine gender confirmation surgery, is a set of medical procedures designed to help transgender men align their physical characteristics with their gender identity. These gender-affirming surgeries can include top surgery (mastectomy), bottom surgery (phalloplasty or metoidioplasty), and others like facial masculinization and voice masculinization. Gender reassignment surgery is common among transgender men, with 42 to 54% opting for these procedures during their transition.
💲On average, FTM surgery costs between $3,000 and $24,900, though more extensive procedures, like phalloplasty, can reach up to $150,000.
The cost largely depends on the country where the gender-affirming surgery is performed. The following table outlines the average cost range for FTM surgery in various countries:
Country | FTM Surgery Cost Range |
|---|---|
United States | $15,000 - $138,000 |
United Kingdom | $13,000 - $74,000 |
$3,500 - $22,000 | |
$3,000 - $12,000 |
Let’s look further into different types of female-to-male surgery and their potential costs.
How Much Does FTM Top Surgery Cost?
Top surgery is a critical part of the female-to-male transition process. It aims to create a male-looking chest by removing breast tissue and reshaping the chest area.
💲The average cost of top surgery ranges between $3,000 and $10,000.
Here's a breakdown of top surgery costs by country:
Country | FTM Top Surgery Cost Range |
|---|---|
United States | $8,500 - $15,000 |
United Kingdom | $11,000 - $15,500 |
Thailand | $3,000 - $7,000 |
Turkey | $3,000 - $5,000 |
🤩Transmasculine chest reconstruction is the most popular procedure among transgender men. It is a low-risk operation that can significantly improve the quality of life and alleviate gender dysphoria. A recent study published by the JAMA Surgery Journal found that the median satisfaction score for top surgery was 5 out of 5.
Top Surgery Types
There are several types of top surgery, each suited to different body types and personal preferences:
- Double Incision. This method involves two horizontal incisions across the chest, allowing for the removal of breast tissue and repositioning of the nipples. It is best suited for medium to large chests with a slight overhang or poor skin elasticity.
- Periareolar. This technique involves a small incision around the bottom of the areola, removing breast tissue while keeping the nipple in place. It is most suitable for small to moderately-sized chests with good skin elasticity.
- Keyhole. This method uses a small incision at the edge of the areola to remove breast tissue without removing the nipple. It's ideal for transgender people with a smaller chest size and tight skin.
- Inverted T or T-anchor. This approach uses a T-shaped incision to remove excess skin and tissue, offering greater control over nipple positioning. It's often recommended for a larger chest size with poor elasticity.
- Fishmouth or "Batwing" Incision. This top surgery procedure uses incisions that radiate outward from the nipple, removing breast tissue while preserving nipple sensation. This approach suits nonbinary people who don’t mind chest scars that do not follow the typical pectoral line.
The type of top surgery also influences the cost. Generally, Keyhole and Periareolar top surgeries are less expensive than the Double Incision method, sometimes by as much as $2,000. However, this can vary based on surgeon expertise, facility fees, and additional procedures like liposuction or nipple resizing.
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🛡️Does insurance cover FTM top surgery?
Yes, insurance covers surgical procedures deemed medically necessary, and FTM top surgery is widely considered a necessary part of the transition for trans men.
How Much Does FTM Bottom Surgery Cost?
Bottom surgery, or genital reconstruction, is a significant part of the female-to-male (FTM) gender transition. Approximately 25–50% of trans men opt for this procedure. It's associated with significant improvements in quality of life, self-image, sexual relationships, dating, and social interactions.
💲The average cost of FTM bottom surgery is $24,900.
🛡️Does insurance cover FTM bottom surgery?
Yes, like top surgery, insurance plans usually deem FTM bottom surgery medically necessary.
There are two primary types of female-to-male bottom surgery: metoidioplasty and phalloplasty. Scrotoplasty, which converts the major labia into a scrotum, can be performed with either procedure. The insertion of testicular implants typically requires a follow-up surgery.
Metoidioplasty
Metoidioplasty is a simpler procedure that uses the clitoris, which has been elongated by hormone replacement therapy (HRT), as the base for the neopenis. This gender-affirming surgery sometimes includes urethral lengthening so that patients can urinate while standing.
💲The average cost of metoidioplasty is $12,000.
Check out the table below to compare costs in different countries.
Country | Average Metoidioplasty Cost |
|---|---|
United States | $19,000 – $43,000 |
United Kingdom | $12,000 – $43,000 |
Thailand | $5,400 – $12,000 |
Turkey | $4,000 – $10,500 |
🤔Is metoidioplasty for you?
Metoidioplasty is a less invasive option best suited for trans people who prefer a shorter neopenis and a quicker recovery. This procedure is ideal for those who do not need to engage in penetrative sex.
Phalloplasty
Phalloplasty tends to be more expensive than metoidioplasty due to its complexity, requiring several surgery stages. Phalloplasty constructs a neopenis using a skin graft from a donor site, such as the forearm, thigh, abdomen, or upper back. A penile implant can be inserted in a follow-up surgery to allow for erection and penetrative sex.
💲The average cost of FTM phalloplasty is $20,000-$35,000.
Here's a table outlining the cost of FTM phalloplasty by country:
Country | Average FTM Phalloplasty Cost |
|---|---|
United States | $42,800 - $75,000 |
United Kingdom | $34,500 - $86,500 |
Thailand | $14,680 |
Turkey | $9,755 |
🤔Is phalloplasty for you?
Phalloplasty is best for trans men who seek a longer and more anatomically typical neopenis. This procedure often attracts those who desire the ability to have penetrative sex. It is recommended for transgender people who are prepared for a longer recovery period and multiple follow-up surgeries.
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📢Don’t miss out on our comprehensive guide to female-to-male bottom surgery!
How Much Does Facial Masculinization Surgery Cost?
Facial masculinization surgery (FMS) is a set of procedures designed to give the face a more traditionally masculine appearance. It involves various surgical techniques to reshape or augment facial features.
💲The cost of facial masculinization surgery varies widely, ranging from $1,000 to $20,000 or more. The exact price depends on the type and number of surgeries performed as part of FMS.
Some common FMS procedures are:
- Forehead lengthening and augmentation to create a more dominant look with lower-set eyebrows.
- Cheek, chin, and jaw augmentation to create square and chiseled facial features.
- Rhinoplasty to make the nose more prominent.
- Adam’s apple enhancement to make it more pronounced and create a masculine-looking neck.
🛡️Does insurance cover facial masculinization surgery?
Insurance coverage for facial masculinization and facial feminization surgery is rare, as they are often considered cosmetic. However, some insurers have begun covering FMS from select surgeons specializing in gender-affirming care.
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How Much Does Voice Masculinization Surgery Cost?
Voice masculinization surgery aims to deepen a person's voice, making it sound more traditionally masculine.
💲The typical cost of this gender-affirming surgery ranges from $5,000 to $15,000.
Voice masculinization surgery is less in demand than other gender-affirming procedures because many transgender men experience sufficient voice changes with hormone therapy. However, if HRT and voice training don't yield the desired results, surgery may be an option. Voice masculinization surgery often involves thyroplasty. This procedure involves removing a strip of cartilage from the voice box (larynx), which loosens the vocal cords and lowers the voice pitch.
🛡️Does insurance cover voice masculinization surgery?
Voice masculinization surgeries are generally not covered by government or private medical insurance, as they're often considered elective or cosmetic.
What Factors Affect Female-to-Male Surgery Cost?
As we’ve seen, the cost of female-to-male (FTM) surgery can differ dramatically. To give you a clearer idea of what your transgender surgery might cost, let’s review the factors driving these differences.
Type and number of surgeries
Since there are many available FTM procedures ranging in purpose and complexity, the total cost largely depends on their type and number. For example, facial masculinization usually involves a set of surgeries, with each increasing the overall expense.
Additional procedures and follow-ups
Some FTM gender-affirming surgeries require additional procedures, revisions, or long-term medical care, which can add to the overall cost. The need for revisions, penile implants, or testicular implants in follow-up surgeries can also increase expenses.
Location
Costs usually vary based on location. Countries or cities with a high cost of living generally have higher prices. Conversely, countries known for medical tourism typically offer more affordable options.
For example, FTM surgeries are the most expensive in the United States and the United Kingdom due to higher living costs, public healthcare limitations, and high overhead costs related to facility maintenance, staff salaries, and malpractice insurance. In contrast, FTM surgery in Turkey is about 68% less expensive than in the US, with a lower cost of living and reduced clinical and laboratory fees. Thailand also offers competitive pricing thanks to a thriving medical tourism industry and lower operational costs.
Surgeon's expertise and medical facilities
Surgeons with extensive experience in gender-affirming procedures often charge higher fees due to their specialized skills and reputation. Likewise, state-of-the-art medical facilities with advanced technology and comprehensive patient care services tend to charge more. The quality of post-operative care, accommodation, and equipment also affects the cost.
What is Included in the Cost of FTM Gender Reassignment Surgery?
The base cost of female-to-male gender reassignment surgery typically includes charges for the surgeon, anesthesiologist, operating room, and hospital stay. However, details can vary depending on the clinic, surgeon, or offer.
Medical tourism destinations like Turkey and Thailand attract patients with all-inclusive packages that may include the following:
- pre-surgery exams and x-rays;
- post-surgery garments and supplies;
- consultations before and follow-up appointments;
- airport-hotel-hospital transfers;
- accommodation in a hotel.
Additional FTM Surgery Costs
Some necessary expenses might arise outside the general estimate or base package. Consider the following points that can add to the total out-of-pocket cost of FTM surgery:
- Masculinizing hormone therapy before or after transgender surgery.
- Costs for traveling to the surgery location and staying nearby during recovery.
- Additional medications for pain management or other post-surgery needs.
- Revision surgeries if further correction or adjustments are needed.
- Expenses for in-home care or assistance during the recovery period.
- Therapy sessions for referral letters from mental health professionals (required for insurance coverage or surgeon approval).
- Post-surgery items such as compression garments and wound care supplies.
- If health insurance covers part of the surgery, there may still be costs related to deductibles or co-payments.
- If you need to take time off work for surgery and recovery, this can lead to lost income.
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👛Is your insurance coverage coming up short? Learn other ways to fund gender-affirming surgeries in our helpful guide here.
Takeaways
➤ On average, female-to-male surgery costs vary from $3,000 to $24,900. However, extensive procedures, such as phalloplasty, can reach up to $150,000.
➤ FTM surgery is generally more expensive in the United States and the United Kingdom due to higher operational and living costs. In the U.S., the price can range from $15,000 to $138,000. In the UK, FTM transgender surgery costs between $13,000 and $74,000.
➤ Turkey and Thailand offer cheaper options because of reduced clinical and laboratory fees, lower cost of living, and booming medical tourism industries. In Turkey, FTM surgery costs between $3,000 and $12,000, while Thailand offers transmasculine procedures for $3,500-$22,000.
➤ The most common type of FTM surgery, top surgery, costs between $3,000 and $10,000.
➤ The cost of FTM bottom surgery varies by type—metoidioplasty averages $12,000, while phalloplasty usually costs between $20,000 and $35,000. Phalloplasty is more complex and requires multiple stages.
➤ Facial masculinization surgery (FMS) can include several plastic surgery procedures, so the cost varies widely, from $1,000 to $20,000.
➤ Voice masculinization surgery is less common and costs between $5,000 and $15,000.
➤ The cost typically includes the surgeon's fee, operating room costs, anesthesia, and hospital stay. Clinics in Turkey and Thailand often add pre-surgery exams, post-surgery garments, follow-up appointments, transfers, and accommodation to their packages.
➤ Out-of-pocket expenses can include hormone therapy, additional medications, travel and accommodation, revision surgeries, therapy sessions, post-surgery items, and lost income due to time off work.
- Investopedia. (2023). Does Insurance Cover Gender-Affirming Care? https://www.investopedia.com/paying-for-transgender-surgeries-5184794
- Healthnews. (2024). What Is the Best Country for Gender Reassignment Surgery? https://healthnews.com/reports/what-is-the-best-country-for-gender-reassignment-surgery/
- Translational Andrology and Urology. (2019). Demographic and temporal trends in transgender identities and gender confirming surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626314/
- Plastic and Reconstructive Surgery Global Open. (2021). Transgender and Gender-nonbinary Patient Satisfaction after Transmasculine Chest Surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099412/
- Plastic and Reconstructive Surgery. (2019). Assessing Quality of Life and Patient-Reported Satisfaction with Masculinizing Top Surgery: A Mixed-Methods Descriptive Survey Study. https://journals.lww.com/plasreconsurg/abstract/2019/01000/assessing_quality_of_life_and_patient_reported.51.aspx