funding

Trans* Jersey

Pathway to care achieved

Trans* Jersey met with Helen O’Shea, Managing Director of the General Hospital, and Richard Jouault, Managing Director of Community and Social Services, today. As a result, we have now had the pathway to care for trans* islanders confirmed, and it is as shown.

Trans* Jersey will be working on getting this into a form that can be distributed to all GPs’ surgeries so that, as the first point of contact for trans* people, doctors know who to refer to and can advise their patients on the pathway to care.

This is the first of our 2014 manifesto goals to be realised. We are, therefore, grateful to the States of Jersey’s health service professionals for their openness and time to assist us, and to those trans islanders who shared their experiences of the health service in Jersey and the UK.

System

Trans* Jersey

Pathway to care – we think…

The infographic below is a first attempt to map the pathway to care for transgender/transsexual Jersey residents seeking to transition. It is based on personal testimonies of islanders who have transitioned and, due to the confusing nature of the system at present, may not match your experience. Please email us if you think you can contribute to our findings.

Apart from cost, the main difference between the public and private routes to care is choice of practitioner and speed. There are set procedures that the public system have to follow when treating trans* patients that include statutory waiting times where the patient must live as their preferred gender before being permitted hormone therapy and/or surgery. These waiting times, largely, fall away when going the private route.

Trans* Jersey is working to clarify the pathway below with the States of Jersey Health and Social Services Department. The question of funding is particularly unclear.

System

Trans* Jersey

MtF finance

Even if you take the publicly funded healthcare route to manage your transition, the costs are higher for trans* islanders than for trans* individuals in the UK because we have to travel to see the specialists who can assist us to transition.

For those transwomen with island medical insurance policies, you will find that they specifically do not cover any treatment relating to gender reassignment.

Below are some of the costs that you will need to fund whichever transition route you follow:

Travel
Flights to the UK for consultations with your therapist. You will need to budget for more than one visit. Depending on how your therapy goes, you could be visiting regularly for a while. The cheapest flights from Jersey to the UK are on the Gatwick route so take this into consideration when you and your GP select your therapist. Your appointment should only be an hour so you should be able to get over and back in the day. Also, remember to budget for the Gatwick Express into London and transport in London.

GP visits
You will need to visit your GP more regularly than usual to keep them updated on progress, to ask for referrals, to have bloods taken to check your hormone levels and to ask their advice on a range of issues. Budget for about one every two months during your first two years of transition.

Change of name
The costs given below are approximate. They may change.

Deed poll prepared by Jersey advocate and sworn in Royal Court: £435
New driving licence: £40
New passport: £75
Passport photographs: £5

See the change of name page for more details.

Devices for passing
Some transwomen like to use breastforms and gaffs to assist them in passing. Breastforms start at about £30 and can go up as high as £750 for realistic skin tone, shape and nipples. Gaffs are around £35-£50. For more information about suppliers see the help page.

financeBelow are some of the costs that are optional depending on how you manage your transition. You may elect to go completely private, completely public through the States and NHS systems, or do a mixture of private and public:

Gender therapy
For those who wish to see a gender therapist privately in the UK, an hour’s consultation will cost about £200.

Hormone therapy
For those who wish to see an endocrinologist privately in Jersey, an hour’s consultation will cost about £280.

Surgery
Bottom surgery (GRS): costs vary depending on the surgical procedure being undertaken. Orchiectomy: £3,000 app. Cosmetic genital reconstruction surgery without vaginoplasty: £9,500 app. Vaginoplasty (penile inversion): £10,800 app. Colon vaginoplasty: £13,000 app.

If you go abroad for surgery, don’t forget to add in the travel, accommodation and food costs. For GRS, for example, you won’t be able to fly for a least a week afterwards, which means a hotel bill. Full recovery time is six to twelve weeks.

Top surgery: costs vary depending on the type of breast augmentation surgery being undertaken. There are two types of implant commonly used. However, you can expect to pay between £3,500 and £5,000.
Facial feminising surgery: costs vary depending on the surgery being undertaken, and there is a large range of procedures you can have done. You can pay anything from £1,000 for a minor procedure to £10,000 for a full facelift.

See the surgery page for more details of MtF surgery.

Funding
The truth is transitioning costs the trans* individual and, because it is still seen as a choice rather than a necessity, especially by insurers, there is little financial help available.

Try to put away £100 of your salary every month into a transition fund or hold a ‘transition fund’ event where friends and family show their support by donating as much or as little as they want without embarrassment.

Don’t fund your transition through credit cards or pay-day loans. These are the worst ways to borrow money as the interest rates are so high. If you need to borrow, talk to your bank about a loan. Trans* Jersey has contacted NatWest bank in Jersey and they have confirmed that they would do a personal loan for treatment or surgery and that anyone who approached them would be treated sensitively and with discretion. Criteria for the loan would be the standard requirements, ie. any person wanting a loan will need to bank with NatWest for 6 months, have a regular income mandated to the account and be able to afford the loan. Anyone seeking this sort of facility can contact Tanya Nerac, Assistant Relationship Manager, in the first instance who is one of our trans* allies.

Trans* Jersey

FtM Finance

Even if you take the publicly funded healthcare route to manage your transition, the costs are higher for trans* islanders than for trans* individuals in the UK because we have to travel to see the specialists who can assist us to transition.

For those transmen with island medical insurance policies, you will find that they specifically do not cover any treatment relating to gender reassignment.

Below are some of the costs that you will need to fund whichever transition route you follow:

Travel
Flights to the UK for consultations with your therapist. You will need to budget for more than one visit. Depending on how your therapy goes, you could be visiting regularly for a while. The cheapest flights from Jersey to the UK are on the Gatwick route so take this into consideration when you and your GP select your therapist. Your appointment should only be an hour so you should be able to get over and back in the day. Also, remember to budget for the Gatwick Express into London and transport in London.

GP visits
You will need to visit your GP more regularly than usual to keep them updated on progress, to ask for referrals, to have bloods taken to check your hormone levels and to ask their advice on a range of issues. Budget for about one every two months during your first two years of transition.

Change of name
The costs given below are approximate. They may change.

Deed poll prepared by Jersey advocate and sworn in Royal Court: £435
New driving licence: £40
New passport: £75
Passport photographs: £5

See the change of name page for more details.

Devices for passing
Some transmen like to use packers and binders to assist them in passing. Packers start at about £12 and can go up as high as £500 for realistic peeing and playing packers. Chest binders are around £35-£50. For more information about suppliers see the help page.

financeBelow are some of the costs that are optional depending on how you manage your transition. You may elect to go completely private, completely public through the States and NHS systems, or do a mixture of private and public:

Gender therapy
For those who wish to see a gender therapist privately in the UK, an hour’s consultation will cost about £200.

Hormone therapy
For those who wish to see an endocrinologist privately in Jersey, an hour’s consultation will cost about £280.

Surgery
Top surgery: costs vary depending on the type of chest surgery being undertaken. There are two methods commonly used. However, you can expect to pay between £5,000 and £10,000.

Bottom surgery: Hysterectomy: £7,500-£12,500. Costs vary depending on the type of penile construction surgery being undertaken. Metoidioplasty: £10,000-£15,000. Phalloplasty: this is complex requiring numerous procedures so you are looking at anything from £25,000 upwards.

If you go abroad for surgery, don’t forget to add in the travel, accommodation and food costs. For chest surgery, for example, you won’t be able to fly for a least a week afterwards which means a hotel bill.

See the surgery page for more details on FtM surgery.

Funding
The truth is transitioning costs the trans* individual and, because it is still seen as a choice rather than a necessity, especially by insurers, there is little financial help available.

Try to put away £100 of your salary every month into a transition fund or hold a ‘transition fund’ event where friends and family show their support by donating as much or as little as they want without embarrassment.

Don’t fund your transition through credit cards or pay-day loans. These are the worst ways to borrow money as the interest rates are so high. If you need to borrow, talk to your bank about a loan. Trans* Jersey has contacted NatWest bank in Jersey and they have confirmed that they would do a personal loan for treatment or surgery and that anyone who approached them would be treated sensitively and with discretion. Criteria for the loan would be the standard requirements, ie. any person wanting a loan will need to bank with NatWest for 6 months, have a regular income mandated to the account and be able to afford the loan. Anyone seeking this sort of facility can contact Tanya Nerac, Assistant Relationship Manager, in the first instance who is one of our trans* allies.