vaginoplasty

Trans* Jersey

MtF surgery

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

Bottom surgery
This refers to genital reconstruction surgery (GRS), ie. a penectomy and orchidectomy to remove the male genitalia and plastic surgery (vaginoplasty, clitoroplasty, labioplasty and repositioning of the urethra) to provide you with a genital appearance that is virtually indistinguishable from natal born women. The phases of the operation are done in one procedure under general anaesthetic and takes about five hours. The Looking Glass Society has a great section on the variety of surgical methods and their advantages and disadvantages.

When considering bottom surgery, manage your expectations. Post-surgery interviews reveal that 98% of transwomen are satisfied with the physical results of their surgery. However, the surgery is irreversible so you need to consider the emotional implications carefully. You will not be able to have children after surgery (unless you make a deposit with a sperm bank first), you may find that your relationship with your partner changes dramatically post-surgery, with potential loss, and genital surgery won’t change how people behave towards you in public life.

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 GRS. 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 blogs and YouTube videos uploaded by transwomen describing their experiences. Visit some of the forums for transwomen and post questions asking about their experiences. Don’t forget to ask about any emotional reactions to the surgery as well as the physical results. Most transwomen are happy to share this information.

surgeryOther surgery
This comes in several parts. The Looking Glass Society explains the range of surgical options available to transwomen. It is exceedingly rare for any of these procedures to be funded through the health service. If you wish to undergo one of these options, you should be prepared to fund it privately.

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

Facial feminising surgery and rhinoplasty
This refers to plastic surgery to feminise the face and/or remodel the nose. Some transwomen find that, even after HRT, their facial features retain a heaviness that is masculine in appearance and does not allow them to pass as they would like to. Cosmetic surgery can help to alleviate this problem.

Thyroid chondroplasty (tracheal shave)
For transwoman who have a very prominent ‘Adam’s Apple’, this procedure can reduce it by making a small horizontal incision in a natural crease-line on the neck and removing part of the thyroid cartilage.

Augmentation mammoplasty (breast enlargement)
Even after one or two years on HRT, some transwomen are unhappy with the breast growth resulting naturally. They, therefore, consider having implants. There are a number of options available now that are alternatives to silicone so do your research to find out which would suit your requirements best.

Hair transplantation
HRT will thicken the existing hair but many transwomen who transition later in life find that they retain a male pattern hairline. Hair transplantation can be effective in “filling in” the gaps at the front of the hairline to produce a more feminine line.

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

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.