Metoidioplasty or Home Down Payment

In stark terms, those who choose to relieve their dysphoria via hormone replicators and psychosurgery must cut themselves off from many advantages in life. Why? Among the costs incurred in seeking to live as the complementary gender is the monetary one. I give the remembrance in the new book, Across the Kitchen Table (did we mention, now available on Amazon?) of one “regretter” who recalled, “I was going to either get the next operation or put the down payment on a house—that was the decision.”

I reproduce in the book a graph of Grand View Research, who produces reports for potential investors and other interested parties in an industry. Even the free version of their analysis is revealing. Consider a paragraph:


SRS (sex reassignment surgery) is an expensive procedure that requires a skilled surgeon and support staff. Patients are required to pay surgeon, operating room, & recovery fees; for anesthesia & drugs; for procedure-related charges; and lab fees in addition to medical expertise. The total cost, including all associated fees, can exceed USD 100,000. Transitioning from male to female is somewhat more expensive than female to male. According to the Philadelphia Center for Transgender Surgery, “bottom surgery” costs approximately USD 25,600 for male-to-female patients and approximately USD 24,900 for female-to-male patients. The center provides estimates for additional common trans-related surgeries, including bilateral mastectomy (up to USD 10,900), breast augmentation (USD 9,000), facial masculinization (up to USD 53,700), and facial feminization (up to USD 70,100).



This analysis paragraph does not cover the much more expensive phalloplasties and overlooks the continuing cost to patients from frequent complications and body-battling maintenance. But it does show why trans is a $2 billion industry that promises to more than double in the next eight years. Take note, Grand View Research would even create such a report unless the investment opportunity promised great gains. Should that raise any flags in our mind about the industry drivers?



Note also, from the above paragraph, how the most expensive procedures involve a person’s face. That is because such operations require a breaking of the face to reshape it, a (rather painful, by the way, when the anesthesia wears off) dislocation and disassembly of that part of us that usually shows forth our gender with subtle and not so subtle features. Here, where we recognize and know each other, where our gender often finds expression, is a locus of our identities. Our faces point us to who we are and how we can love one another. They must be broken to pursue the course of gender imitation. That is the tragic reality.



Grand View Research, I find, is continuing to update its data on the trans industry and potential for investment.

That can only mean that they expect explosive growth.


  1. Steve Goble

    Sam, thank you for bringing the money component of this issue to light. This is very sad and alarming. With big money involved, it appears there is now a guild of compromised professionals who cower from providing real and effective help to those who suffer with transgender feelings. Earlier in life, I experienced transgender feelings (among other issues) and am grateful our loving Lord placed the following tools for healing and gender development in my life: change-allowing therapy, transformational ministry and quality friendships. Slowly over time, my capacity for healthy relating increased, and the transgender feelings evaporated and are not a problem. This issue has became politicized, worldly, confusing and deceptive. However, many are recognizing the deception, pursuing the truth, and experiencing healing and transformation.

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