Planning To Pay For Top Surgery Taught Me To Be Good At Budgeting

Since I got my first job, saving up for medical transition shaped my ability to budget — for better and for worse.

My boyfriend confessed he was $15,000 in debt. We were at a bar in Brooklyn, sitting beneath some trendy Edison bulbs hanging from the ceiling. It was a warm summer evening and I was drunk. The bar wasn’t particularly crowded and the music was low. I asked him to repeat the number again, then laughed.

I started jotting down numbers on a napkin, gesturing with my $8 beer as I explained how easy it would be, within a year, for him to pay it all off with the salary from his new job. He looked a little lost. I scoffed when he told me he didn’t know how much he spent on food in a month. At 25, I could tell him how much I spent each month on food going back almost eight years.

When he asked me how I got so good at budgeting, I told him, simply, “I’m transgender.”


I was 14 and deep in a Gaia Online forum when I first learned that if I wanted top surgery, I would need to save up anywhere between $8,000 and $14,000. I opened the calculator app on my slow-loading PC and did some quick math. Based on my allowance, it would take 13 years for me to earn that much money on my own.

Hormone replacement therapy can be costly, and surgery even more so. Over the past five years, my hormones have cost, on average, $10 a month, but I have paid as little as $2. Most states do not require insurance to cover transgender-specific health care needs, however, and that was the case in Georgia, where I grew up; early on, without some clever insurance tricks by my doctor, HRT would have cost me as much as $2,000 a month — or it would have, but I opted to go off of hormones for a time while I figured out my insurance situation. After months of jumping through ridiculous bureaucratic hoops, I learned to refill my prescriptions a few days early each month in order to have a backup supply.

I am the kind of person who likes to have a plan.

As a teenager, I didn’t feel like I could tell my conservative parents what I was dealing with. I had seen enough of my queer friends come out to then disappear to a different school, different state, different country, the next year. I loved my life in Georgia. There were some risks I was not ready to take. It never occurred to me to ask for their help.

Instead of asking them for financial assistance, I happily got my first job. At 16, making $7.25 an hour at Chick-fil-A, my savings account began to grow. In Georgia, the fast-food joint has a strong reputation for good Christian values and excessive customer service (the chain is known nationally for the founder’s frequent donations to anti-gay charities, such as Focus on the Family). I loved my coworkers, including the man whose main job was cleaning the dining room, but would kick you off of the drive-thru window if a particularly attractive man came driving up, though we never discussed it. I loved working drive-thru. I frequently played with dropping my voice over the drive-thru headset. In a culture filled with “yes ma’am” and “no sir,” I was easily able to gauge where my voice needed to sit; I wanted to know how low I could throw my voice. People never made the connection between the voice on the speaker and the redhead with pigtails at the window. The work was steady and my manager would blast Lady Gaga come closing time as he would twirl around the store with a mop.

I didn’t tell anyone I worked with why I was stockpiling money. Generally, the unemployment rate in the United States is around 9%, but for transgender people, it is more like 16%. And 1 in 5 will experience homelessness at some point in their lifetime. Debt is endemic to my generation and the costs of transition can quickly sink a person deeper into the pit.


Financial security was one of the most important values my parents taught me. I was 8 when I got my first savings account, mostly as a place to put money I earned from feeding the neighbor’s dog and taking out the trash. I was in the Girl Scouts for years and, in middle school, as part of a requirement for a badge, my family was supposed to discuss what we would do if we became homeless, as an exercise in empathy. My father refused to play along. “I will never be homeless,” he said. I remember wanting to argue with him; anyone can hit unexpected hiccups, I had been told. Layoffs happen when you least expect; people get sick; accidents happen. He wouldn’t explain why he was convinced we were immune from the threat of losing our livelihood. That I had to learn on my own.

When I did decide to start medically transitioning at 19, I sat down my parents in their warm living room. The TV was playing some muted crime procedural. I gave them the option of two budgets: one, where they would continue to help me with paying for housing and food while I attended college; and one for if they did not feel they wanted to be a part of this new life I was pursuing. By this point, I had already moved away for my first year college and knew that I could handle living on my own. I was scared, but I was more scared of what would happen if I didn’t have this conversation.

They said they wouldn’t financially support my transition, but they were determined that I would get through college with their support. My tuition was paid for with a full-ride scholarship, and they agreed to keep covering my housing.

When I had first come out to them a few years earlier, my parents made it clear that they didn’t want me to talk to much about my trans identity, lest I draw attention to myself. But testosterone quickly shifts the face, making my transition impossible to hide. My mother began to cry when I explained that I was ready to be cut off from them. I didn’t know how to explain that their lack of outright rejection was not enough to make me feel safe.


I scheduled my chest surgery when I was 21 and still in college. It cost about $10,000 out of pocket; I paid for it in two payments to cut down on the trauma of seeing my bank account take the nosedive. Through working and hustling my way into multiple jobs, I had been able to afford to do this for myself.

The biggest shock of my post–top surgery life was that I didn’t know how to handle my finances — if not logistically, then emotionally. If I bought a big-ticket item, like a more expensive meal at dinner, I broke down, worried I was wasting my money. My father’s voice echoed in my head: “I will never be homeless.” I had learned so many methods of saving that no longer serve me.

I rarely go out to eat. I want to hide away from chatty waiters and their shifting facial expressions when they take in the disconnect between my face and my voice. I hate having to add tax and tip to the cost of my meal when I can cook pretty well at home.

The biggest shock of my post–top surgery life was that I didn’t know how to handle my finances — if not logistically, then emotionally.

I stopped paying for haircuts after an ex took me with him to his hairstylist with his mother, to whom I wasn’t out. I found myself stuck in a chair, unable to communicate what I wanted; the stylist made me look like Velma from Scooby Doo. I fought back tears as I paid $80 for a haircut I hated, and I cried again when I spent $25 on a buzzer so that I would never need to pay for a haircut I hated again.

After graduation, I packed two suitcases for New York City because that seemed to be where all the queer writers were. My $700-a-month room was so small that I couldn’t fully open the door because the bed got in the way. Working multiple internships and jobs, I made about $20,000 a year for the first few years. I kept dreaming of that full- time job, coming up with budgets for different incomes, with different breakdowns. Oh my phone, I would fiddle between different apps — my bank, my budget, my credit cards. It became my way to pass the time, to relax.

At 25, I got a job that more than covers my cost of living, but I still save, keeping detailed records of my every expenditure. My nights out are filled with calculations of the $1 pizza and the $6 fries at the bar plus two $8 beers and my brain starts to have trouble holding onto the numbers; even though I can afford the drinks now, my obsession with saving gets in the way of having a good time.

My boyfriend recently treated me to brunch, complete with syrup-drenched French toast and fluffy omelets, about $40, and I asked him to make sure that he was still keeping up with his budget, even though I knew that that this was supposed to be a celebration of him keeping to his budget so well that he could afford a small splurge. I asked him the same question when he gifted me monogrammed oven mitts and a Kehinde Wiley art book for my birthday.

I describe this neurosis to friends who are fighting off debt and they roll their eyes. I get it. I get how it sounds to worry that I am depositing too much money into my savings account. I currently have enough money in my savings account to live for about six months with no income. But I still don’t feel safe. ●


Parrish Turner hails from Georgia. He is an editor and essayist. He was a Lambda Literary Fellow in Nonfiction in 2014 and received his MFA from the New School for creative nonfiction in 2017. Parrish’s work centers around regionality, gender, sex, and religion. He currently works at Culture Trip as its NYC-based books editor.

This story is part of a series about debts of all kinds.

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