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"The lure of wanting do something like that is there," says Omaha, Nebraska, resident Kitty Shanahan, who is 27, a debit card specialist at Pay Pal, and in the process of transitioning from male to female. Sounds great, but do they want to make you do something you don't feel comfortable with? There's always the desire for the easy way, but there's also always a catch." Another popular method to save money is by having sex reconstruction procedures done abroad.There are online guides galore, as procedures can be significantly less expensive in the Philippines, Mexico and Thailand. For something that important, you need to have the exact right doctor to make sure you have the best outcome." says Shanahan. Reputable online guides for doctors who perform sex reconstruction in the States are published on Planet Transgender."I include them in my transition costs because of the lack of access to care, underemployment, anxiety and weight gain, all as a result of being trans." In a recent report issued by the Center for American Progress, transgender people experience unemployment at twice the rate of the population as a whole.Mc Cormack is still waiting on "top" surgery, after having completed hormone therapy, and has researched physicians based on price and procedures offered.With a will, of course, there is always a way, but the physical and financial side effects of some methods can be risky.

A female transitioning to a male may elect for top procedures such as the removal of breasts with a bilateral mastectomy, then reconstructive surgery to simulate a more masculine chest.

The final cost for her procedures will be around ,000, but the out-of-pocket costs will be only about ,000. In the end, says Mc Cormack, "Do whatever you can to make yourself more comfortable with your body.

"Bottom surgery is mainly covered," says Shanahan, as is travel to California, where the surgery will take place. "I have to pay a lot upfront for electrolysis and that's per hour." As generous as her insurance plan is, reimbursements are slow. But the truth is your gender is not dependent on any procedure.

Most who want gender reassignment will not let anything get in their way, contends Mc Cormack.

"Often when a trans person comes to the realization, any kind of rational considerations, like finances, are not important." Unsurprising is the trouble that desperation can lead to: decisions with unintended, often dangerous consequences.

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