Cost of Gender: Transgender Americans seek healthcare in Thailand

The Cost of Gender shares the stories of transgender Americans faced with health care discrimination at home, who look to Thailand for better options.

Barriers to Health

Rev. Carla Robinson, an Episcopal pastor in Seattle, WA, is fully insured. But a line item on her insurance papers says transgender-related health services are not covered, citing sex reassignment surgery as “cosmetic.”

“For me, it’s a question of what I need to be healthy,” Robinson said.

This is a reality for almost every transgender American who pays out-of-pocket for everything from hormone therapy to mental health counseling to sex reassignment surgery. Even routine services, like a breast exam, can be denied coverage for a trans man if his gender is changed from “F” to “M” on medical forms.

Filling the void, Thailand’s trans health industry, pioneered by world-renowned Dr. Preecha Tiewtranon, is a hotspot for trans patients seeking affordable care. The difference in cost averages around 70% less than full-price procedures in the U.S. and the surgeons bring an entirely different approach to patients.

“I think doctors should be a part of the movement,” Dr. Preecha said about his role in shaping progressive health policy. Add to the mix a highly trans-visible culture with activist groups like Shade of Divas, its clear how Thailand became the mecca it is today.

Robinson hopes to be able to get there herself one day.

Rev. Carla Robinson
Rev. Carla Robinson

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