FtM surgery

All surgery is optional. You should not feel that you have to have surgery to validate your transition from F to M. You should have surgery because you want to have surgery and for no other reason.

Top surgery
This refers to a double mastectomy to remove the female breasts and plastic surgery to build a male chest. The two phases of the operation are done in one procedure under general anaesthetic. Hudson’s Guide has a great section on chest surgery methods and their advantages and disadvantages.

When considering top surgery, manage your expectations. You will have scarring, whichever method you choose, you may need revisions post-surgery, and your final chest is unlikely to look like a natural male chest close up. However, with gym work to improve the tone of your pecs, most post-op transmen would pass on the beach at St Ouen’s.

There are no surgeons available on the island to undertake this procedure so you will need to go to the UK or abroad if you want chest surgery. If you are being treated through the NHS, you will be offered a list of approved surgeons to choose from. If you wish to go privately, you can choose from surgeons in private practice all over the world. However, you will need to research the best person for your needs and your budget.

Do your research. Look at the numerous YouTube videos uploaded by transmen showing pre and post-surgery photos. Compare the pre-op photos with your own body shape. It is no good admiring the chest of a transman who started off as a B cup if you are a D cup! If the post-op results look good to you, send a comment to the transman who posted the video asking who his surgeon was. Most transmen are happy (and flattered) to share this information.

surgeryBottom surgery
This comes in two parts.

Hysterectomy and oophorectomy
This refers to the removal of the uterus and ovaries respectively. After taking testosterone for a while, some transmen may find that they have to have one or both of these procedures for medical reasons. Hudson’s Guide explains the reasons for this surgery and the surgical options available.

Jersey has the necessary surgeons capable of performing a this surgery through the health service. If you have island health insurance, you may also find that this is the only part of your transition it will cover, especially if you have to have the operation for medical reasons, such as the development of cysts. However, you may wish to go privately in order to choose the surgical method used by your surgeon.

Genital reconstruction surgery (GRS)
The surgery to contruct a penis and testes is the surgery that majority of transmen elect to do without. The results still ask transmen to trade-off sexual function and visual appearance, there can be complications, it is by far the most costly and time-consuming of trans surgeries, and can involve numerous surgical procedures. Details of the various options currently available to transmen can be found on Hudson’s Guide or can be downloaded here (warning: this download contains graphic photographs of operation progress and results).

You will not be surprised to learn that there are no surgeons with the required skills to perform GRS in the island. You are therefore looking at travel costs again and, because of the complexity of the surgery, several trips to the UK or abroad may be needed.

The same advice applies to GRS as for top surgery: manage your expectations and do your research thoroughly.

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:

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.

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.

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.