Financial Planning for Gender-Affirming Care: A Step-by-Step Guide

We know the cost of gender-affirming care can feel overwhelming. A financial plan won't make that cost disappear, but it can help you feel more supported and in control as you work toward your goals.

In this blog, we'll walk through how to build a financial action plan for your gender-affirming care, step by step. And while this guide focuses on gender-affirming care, you can use the same plan for any financial goal!

What Is a Financial Action Plan?

A financial action plan is more than just a budget. It can help you feel more in control of your care and your future. An effective financial action plan includes at least three things: a financial inventory, a strategy, and support.

Step 1: Take a Financial Inventory

Set aside some time to look at your financial baseline. Grab a coffee or your favorite drink to help set the mood. Here's what you're going to look at:

1. Income: Calculate your monthly income. This isn't just your annual salary divided by 12. Look at your most recent paystub or direct deposit, and find your monthly income after taxes, retirement savings, and other deductions. If your income varies month to month, calculate your average income over the past six months. Include other reliable income streams, like side gigs or business income.
2. Expenses: Review your most recent full month of expenses, including rent, groceries, gas, subscriptions, insurance, and debts like student, personal, or car loans. If you're new to tracking your expenses, you might download a free* budgeting app to track and categorize them. Most apps will let you categorize past months' expenses, too. Rocket Money and NerdWallet are great options to start. Your goal here is to answer: How much do I spend each month, and what do I spend it on?
3. Current savings balances: If you've already started saving for gender-affirming care, awesome! If you haven't, that's okay; that's why we're creating a financial action plan. Take a look at what you currently have saved. Be sure to include any health savings account (HSA) or flexible spending account (FSA) balances!
4. Other accounts: It's always good to have a picture of your other assets, such as brokerage and retirement accounts.

*Some apps mentioned may include premium features that require a paid subscription.

Step 2: Build Your Strategy

A strategy includes budgeting to save for future expenses, but it also helps you find the best way to pay, set your timeline, and create realistic tasks. This section asks you to make some detailed cost calculations. LGBTQ AdvisorMatch's gender-affirming care cost calculator is also a great place to start for a high-level picture of what your expenses may look like.

There are three parts to a well-rounded strategy:

1. Assess your needs

Get quotes, schedule consultations, and plan for post-surgery care, if it applies to you. Expenses for hormone therapy will look different than expenses for surgery, because they're spread over a different period of time. Be as thorough as possible during this step, including:

• Define your gender-affirming care goal(s)
• Find reputable medical professional(s) who take your insurance (if applicable)
• Note how often each expense comes up (e.g., monthly or one-time)
• Get quotes and research typical costs in your area
• Consider post-procedure needs, if applicable, such as recovery time or physical therapy. If you'll need time off work, our guide to PTO, FMLA, and disability leave for gender-affirming care can help you plan.

2. Find out what insurance covers and explore funding options

If you have insurance, start there. Find out what your plan will cover by reviewing its deductible, coinsurance, and out-of-pocket maximum. Check out Point of Pride's resources on using insurance to pay for care.

If you can choose your insurance during open enrollment, do some research to see what each available plan will cover. Visit out2enroll.org to check for insurance plans in your area and learn more about inclusive health insurance.

Next, review some other ways you might cover expenses:

• Budget and save over time in a high-yield savings account
• Apply for grants. Grant funding is highly competitive, but it's still worth the effort! Point of Pride offers financial aid towards surgery, hormone therapy, permanent hair removal, and other types of care. Each program has its own requirements and timelines, so check them out to learn more!
• Start a mutual aid or GoFundMe campaign, which can be a great option with the right approach
• Use a payment plan or financing through companies like CareCredit
• For more fundraising ideas, check out our blog on 6 Creative Ways to Raise Money for Your Gender-Affirming Surgery

3. Plan your time and money

Now that you know roughly how much you'll need for out-of-pocket expenses and how you plan to pay, you can start budgeting your time and money to cover the difference! You can use the cost calculator again to check your numbers. Depending on your funding method, here's how you might plan your time and money:

• Add costs to your monthly budget and start saving in a high-yield savings account, HSA, or FSA.*
• Set aside time to research and apply for grants, and create calendar reminders for grant deadlines.
• Create and share your mutual aid request. Review similar requests, or ask friends and community members for feedback.
• If you choose a financing plan or credit card, such as CareCredit, create a budget that accounts for your expected monthly payments. Consider setting aside money before taking on the expense. Planning and saving ahead of time can make payments more manageable and help you pay off your balance on time. Before you apply, our guide to CareCredit for gender-affirming care explains how it works, including its pros and cons.

*Review eligibility and restrictions for FSA and HSA accounts to make sure these types of accounts are suitable for your budgeted expenses. SoFi Bank is a reputable bank with positive reviews for their high-yield savings accounts.

Step 3: Build Your Support System

A support system makes a huge difference in sticking with your financial action plan. Supportive people can help you stay committed to your goals and troubleshoot when things don't go exactly as planned.

This can look like finding a body double (someone who keeps you company while you work through a task) to help you take your financial inventory, creating a financial action plan with someone who has similar goals, or even working with a financial advisor in a more professional capacity. Finalize your financial action plan by connecting with folks who can uplift and encourage you over time!

You've Got This

Planning for gender-affirming care can take time, and every step you take toward your care is worth celebrating, including this one. You deserve care that helps you feel at home in yourself, and you don't have to get there alone!