A quote from Tennesse Williams - We are all sentenced to solitary confinment in our own skins. for life.

 For some this is a minor inconvience. But, if you happen to be Transgendered, more often than not this solitary confinenment

causes a semi-controlled insanity for many of us in this "statistical anomolly" (as conservatives would discribe us).

For those of us without a "postive support system" there is a pattern of movment in and out of our own versions of insanity (obsess and purge). There are monetary considerations as well. Most major insurance still does not cover "gender disphoria" treatment. for person who in my case is (MTF) treatments are prohibitably high.

I have not check pricing for years but, for implants your talking  9 to 10 thousand dollars. You have ongoing counseling costs, (you need to live full time under a  counseling therapist,and a Doctors care (for hormones and other issues) for 2 years to even qualify for a recommendation for Bottom surgery.

 A point I used when "lobbied" elected officials. Take two men approx 35 to 40 years old. One man needs a heart bypass operation (up to $200,000, just checked). One man presenting with gender disphoria as cost of gender reassignment (bottom sugery $25,000, top/implants $7,800 to $10,000, $35,000 total).

Give each of these patients recovery time from their surgeries (Remenber Patient 1, up to $200,000 is most likely covered by insurance. Patient 2 up to $35,000 most likely not covered by insurance.)

Patient 1 will never be able to do all the things they could do prior. There is aslo the mental issues of not being able to be what ypu once were. Bottom line, future productivity challemged in a major way.

Patient 2  who is now it a situation of posessing congurance of thie body and mind for the first time ever. With the positive outlook on life patient 2 has the potential to exceed their previous potential with their new attitude.

So Patient 2 can be potentially happier and lead a fuller life than they ever have. Patient 1 can return and be a productive member of society but, more than likely will not be able to return to their previous productivity.

Which is a great reason to not cover "Gender Disphoria" with insurance. the Patient is more productive for society  at 17% of the cost.

  Each year in the United States, at least 240,000 coronary artery bypass graft (CABG) surgeries are performed, according to statistics published by the American Heart Association.,  There are about 9000 transgender surgeries being performed annually across the United States (US). The latest statistics indicate that 0.6% of the US population identifies as transgender.

 Qucik math problem (1) 240,000 (number of bypasses per year) x $200,000 (avg cost of bypass usa)= $48,000,000

Qucik math probelm (2) 9,000 (number of MTF sirgeries per year us) x $35,000 (avg cost of Bottm and top sureries usa) = $315,000,000 

 For effect Math example 1 is incorrect total is actually $48,000,000,000 

So for Conservatives that love to crunch economic numbers and determine (ROI) or Return on Investment. In the US we spend $47,685,000,000 more on Heart Bypass the Gender reassisnment. And of those Bypass patients nearly all will never be at 100% produtivity. 

  This means that if you were given a billion dollars and told to spend it in one year, you would have to spend a minimum of $2,739,726 a day to reach zero by the end of the year. (source; The True Value of a Billion Dollars, by Kiah Swenson) 

Oh, and you need to do that 47 times to spend $47,000,000,000 or spend $128,767,122 per day to spend in 1 year.

Transgender men reported lower quality of life than both female and male norms (Newfield et al., 2006). However, a review of quality of life after hormone therapy and transition indicated that the majority (80%) showed improvement, including more stable relationships, better psychosocial adjustment, overall happiness and contentment (50, 51). Perceived financial, professional, and employment status also improved. (source; Adult Development and Quality of Life of Transgender and Gender Nonconforming People, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809047/)