FTM Surgery Costs

By Nick Peplow·Gender-affirming surgery coordinator

Last reviewed 27 September 2026· How this site is researched

The same operation can be free through a public health system, cost a deductible and some co-insurance through a US plan, or run to five figures paid privately. Which of those applies to you depends on where you live, who is paying and how long you can wait. This section gives the numbers, then explains the systems that decide what you actually pay.

The numbers

Costs by procedure has self-pay ranges for every procedure on this site, in the US and Thailand, matching the tables on each procedure page. To give a sense of scale, US top surgery is typically $6,500 to $14,000 depending on technique, a hysterectomy $10,000 to $20,000, metoidioplasty $10,000 to $50,000 depending on how much is done, and phalloplasty $50,000 to $150,000 or more across all its stages. Thai hospital packages for the same operations usually come to about half the US figure or less, before flights and the weeks in Bangkok.

Before you budget around any of those, read hidden costs. Consultations, hair removal before phalloplasty, travel, a companion's time, supplies, revisions and above all time off work sit outside the surgeon's quote. For private top surgery they can add a fifth to a third again, and more if you have no sick pay.

Who pays

In the US, insurance is where most of the complexity lives. Whether your plan covers the procedure, which surgeons are in-network, what counts as medically necessary and how to appeal a denial matter more than any sticker price. Top surgery and hysterectomy are the procedures most often approved; facial and body work is usually refused as cosmetic.

In the UK, the NHS pathway funds top and genital surgery, but only after a gender clinic assessment, and waits for a first appointment have run to years. That wait is why so many UK readers end up weighing private surgery. Canada, Australia and Europe each have their own page because each system works differently, from provincial funding in Canada to a Medicare gap in Australia. Each describes the shape of the system and dates it, so you know what to ask and who to ask; your own plan, province or clinic has the final word.

Paying yourself

If you're choosing between waiting and paying, private versus public sets out the trade-off. Public is cheaper or free, slower, and gives you less say in who operates. Private is faster and you choose the surgeon, but you carry the cost and sometimes the follow-up.

If the total is more than you have saved, financing prices out the borrowing, with a worked deferred-interest example, and covers grants and crowdfunding. Surgery abroad looks at Thailand and other destinations, and what they save once travel and a longer stay are added. My own work is coordinating international patients through Bangkok hospitals, so treat me as interested rather than neutral on that page, and read it for the arithmetic.

One habit from the consultations I've sat in on is worth adopting whatever route you take. Ask for the quote in writing, with anaesthesia, the facility, post-op visits and the revision policy each named on it. An "all-inclusive" price that doesn't list them usually isn't.

All figures in this section are approximate, dated by each page's review line, and they move. A written quote from the surgeon or hospital is the only number to plan around.