Sex reassignment surgerythe ultimate goal of most trans people. Surgery is often expensive and SRS is no exception. Even the cheapest in Thailand is going to cost thousands of dollars after airfare, hotel and miscellaneous expenses. Unfortunately, many of us don't have well-paying jobs, graduate degrees, savings, nor the ability to borrow that kind of money. Some are disabled and unable to work.
The cost of SRS varies significantly depending where you go and which surgeon you see. If you're on a budget I recommend checking out overseas prices that are usually cheaper. Thailand has been a popular choice, but there are many other countries.
If you have health insurance try to have hormones and surgeries covered. Some insurance companies have exclusions for gender identity related procedures, claiming SRS is "cosmetic," "elective" or "experimental." However, some insurance does cover SRS. Check your insurance manual, or HR, to see if gender identity procedures and medications are excluded.
If you checked out the link above then you read the story of a FTM who forced Medicaid to cough up over $80k for his gender surgeries! If you're disabled, or low-income, I recommend following his path and trying to have Medicaid cover your surgery, just as any medically-necessary procedure. If denied, use the appeal process. Don't just stop at the first denial!
Another option is moving to California. As far as I know, their public health insurance (Medi-Cal) will cover SRS. Also, anyone who is an employee of any campus of the University of California will be covered. Obviously, getting the latest information from the appropriate social service agencies before making the decision to move is essential.
If you can work, Medica insurance in Minnesota covers SRS, as well as gender therapy and hormones. That will require moving to Minnesota, but if it gets your SRS why not?
Apparently, Minnesota's public assistance covers SRS. Contact Minnesota's social services to find out about their current policies.
There are ways to get around insurance exclusions. Sometimes hormones can be covered if your doctor uses "hormone imbalance," or some other non-gender identity related, diagnosis. Gender identity counseling can be often covered if your therapist uses an "anxiety" or "adjustment disorder" diagnosis code.
This is from Blue Cross/Blue Shield: "Our Medical Affairs Department indicated that it is generally accepted among professionals that an adult with gender identity disorder who experiences anxiety and stress as a result of the disorder should be treated. Mental health services billed with an anxiety or adjustment disorder diagnosis code would be covered under the mental health benefits available on the plan."
Free hormones. You can sometimes get free hormones from a doctor by asking for samples. Doctors sometimes get free samples from drug manufacturers. I once was given a grab bag of different types of estrogen from a doctor that lasted for months!
Some provinces in Canada (I believe Alberta does) pay for SRS, but from what I understand it's becoming more difficult. It also may be difficult to become a Canadian citizen if you don't live there. If you want to try. There are websites that have information and how to apply. Check for the provinces that still pay for SRS.
If you're able to work and make good money this should be a no-brainer, though
some people say they can't find a job, or are just too lazy to work their
butt off for awhile. When questioned, I usually find out they can't find employment
either because of a bad job market in their area, or there are few jobs that
match their qualifications. If your passability is an issue you may have difficulty
finding a job due to discrimination. In this case, the answer is move somewhere
there's a better job market and / or a trans-friendly area with gender identity
anti-discrimination statutes. Then I'll hear, "I don't want to sell my
house" or "I don't want to move where it's cold." Then you
don't want your SRS enough!
"I can't afford to move." There are ways around that. Find someone with a garage, basement, or space where you can store everything but your essentials then drive, take a bus or train, to somewhere with a better job market. When I moved to Oregon 20 years ago, I had one suitcase with a few changes of clothes, some plates and silverware. I rented a studio apartment before I moved so I'd have a place to live when I got there. The next day, I canvassed the city with resumes and got a job in three days. Check the area's job market you're considering and, if you can, find employment before moving.
Barter is the oldest form of money. You may not be able to pay for SRS through barter (who knows, maybe you can!), but there are other things, like electrolysis, that you may be able to. Does your electrologist have a computer? Can you work on computers or do website design (also ideas to start a business)? Does her office and / or house need regular cleaning? Offer your services in exchange for treatments.
The costs of medically-necessary gender identity procedures, i.e. SRS, facial feminization surgery, etc are tax deductible.