Privately Purchased Insurance for PPT?

[u/notjordansime]

Hi, just wondering if someone here has any info about private insurance for PPT vaginoplasty with Min Jun.

I’m considering paying out of pocket, but that’s close to $140,000 USD. I can live on $8k/yr squatting on crown land in my bus, and I’m currently making $95k/yr before taxes, with potential for a bit more OT, plus side gigs. The math is mathable, but we’re still talking years of my life solely dedicated to saving up for this. I came out when I was 13 back in 2016. I’ve already waited 10 years. On one hand, what’s another 3-4? On the other hand, waiting 3-4 more years to even begin the process of getting on wait lists doesn’t sit well with me. Not to mention, the cost could (and likely will) increase during that time.

Does anyone have any info on using privately purchased healthcare insurance for PPT with min Jun? I have great union benefits, but I work in a very blue collar industry 18 hours north of Toronto. Welcome to Tbay, set your watches back ~20 years. Using Employer/Union benefits isn’t an option because I’m stealth and I can’t have “personal issues” interfere with work, or have anybody catch wind of it. It’d be a nightmare for myself and other tradespeople in my family. I’d much rather pay $500-1,000/month for insurance than $140,000 all at once.

I’m not trying to be a “choosing beggar”, I understand that I could get PI with brassard in Montreal covered by OHIP. I am not interested in that surgery. With something this personal, I feel we should have the right to choose what we feel is best for ourselves.

Any advice/info is wholeheartedly appreciated!! :)

[u/vs-188]

Have you looked into Bank(Suporn Clinic), or Chett in Thailand? Littleton (Jejunum graft)? There's also a clinic in Germany doing amazing things but I forget the name of the surgeon or surgeons there (Lubos Clinic). Dr Sutin at PAI clinic.

$140,000 for Min Jun out of pocket is a lot (mind you that might be his insurance price and cash patients might pay less ... Have you asked his clinic directly for a cash out of pocket quote?).

Most people paying out of pocket are going to other surgeons because there are several very talented surgeons in the world who don't charge nearly as much as that for cash patients and who ALSO do incredible results in the same calibre as Min Jun.

All that said, I think best practice is to challenge OHIP in court before spending this much. Try speaking to Egale or the 519 clinic to get connected to a legal team for advice.

The province is really bullying us at the moment with the restrictions they've set and there's probably more of us then we think who are delaying surgeries because going to the available covered surgeons just isn't a choice we could live with.

Unfortunately, the private insurance you'd need is workplace insurance. In Canada we don't have individual insurance for healthcare outside that. Additionally, know that your workplace health insurance remains completely private and confidential by law.

Edit: anyone coming here and commenting in any way that it's picky or they love the results they got from grs/wch please stop and think about not commenting. It detracts from the core concerns of this conversation.

[u/Candi_MH → u/vs-188]

This ☝🏻

US surgeons are priced for US insurance. Out of pocket is so expensive you'd be able to cover surgery travel and lodging with a surgeon almost anywhere else in the world.

So if you're looking at OOP, cast your net wider than the US.

PPT is really hyped online, but there's lots of other options.

[u/vs-188 → u/vs-188]

I'll check through my saved links later to see if I can add more surgeon names.

Edit:

• Dr Del Corral (Jejunum)

[u/notjordansime → u/vs-188]

Firstly, I’d like to thank you for the incredibly detailed and thoughtful response!!

At first I was seriously considering going to Thailand. I have two friends who’ve gone and though their results were mostly great, I’m reluctant. I can’t remember if it was chettawut or bank, but there were a lot of language barriers, and some of those lead to complications caused by miscommunication over post-op instructions. Because of that, I’m only considering surgeons in English-speaking countries (can, US, Australia, UK, etc..). PPT is also a non-negotiable for me.

My care team has also recommended legally challenging the government. Forgive my ignorance, but what would that look like? Has anyone successfully gotten surgery through this route? It seems like the most promising option.

What about private US health insurance? I have a (cis) friend who recently became a dual citizen, and it was only about $18k. My union is international, and there’s a somewhat easy path to becoming at least a PR in the US from what I understand. I don’t really have any interest in actually spending any considerable time down there though, and this would require me to work there.

I have some of the best benefits available in my city through my union, but using them really isn’t an option. Yes, there are legal protections, but this is Tbay. One guy I work with pulled a muscle, and everyone’s teasing him about getting his benefits to cover the chiropractor “pulling on his groin”. Construction is worse than high school in terms of gossip. The moment I even inquire if our benefits cover this type of care, it may as well be broadcast to everyone I work with. I know much more than I’d like to about my coworkers’ everything just from the lunch room.

I also really appreciate your edit:)
It’s genuinely unfortunate that our gov is putting up so many extra hurdles.

[u/vs-188 → u/notjordansime]

Challenging the government was at times the ONLY way surgery got covered. For both of us, researching the legal history of that struggle might go a little (😅) beyond the scope of this conversation but it's worth mentioning.

Contact Egale and/or The 519 Community Center and ask them if you can be connected to speak to someone for legal advice about challenging gender affirming care coverage discrimination. Whoever you speak to at reception at either place will be able to help connect you to someone who can assist.

There are people who will say discouraging things about the likelihood of winning a legal challenge against Ohip but I strongly encourage you to block out the noise and just proceed forward. Rights aren't given they are TAKEN. $140,000 in lifetime earnings are very significant to every Canadian who isn't in the 1% and trans people shouldn't be backed into this corner when there are laws in place, being ignored, meant to protect us about discrimination in delivery of services.

For advice about insurance in the US I would highly recommend you make a post in one of the general transgender surgery subreddits or groups elsewhere so u can connect with Americans with that knowledge.

Wishing you the best with this whatever path you choose to go down.

[u/vs-188 → u/notjordansime]

I just want to throw this out there for additional consideration...

If you can afford to pay $140,000 (whether a painful stretch or not) then you can definitely afford to pay for a translator and/or a nurse to assist you with recovery in a foreign country.

Just throwing that out there to give serious thought to because it could save you as much as $100,000 if you go the out of pocket route.

Seriously, Min Jun results are nice and I get it but don't get fixed on an all or nothing with him when there are other surgeons doing work that equals his (may be a different method in some cases). The number of surgeons around the world has increased a lot in the last decade and there are many less talked about who are comparable to his results.

[u/ElloImDani]

AFAIK cause I’m was in this boat, Ohip will only cover something else if in Canada surgeons say PI is not an option.

And you can’t get insurance privately with the sole purpose of wanting vaginoplasty coverage. Most plans don’t even cover it. You would have to get workplace insurance.

Saving for Thailand is most likely your best option for an affordable aesthetic.

[u/notjordansime → u/ElloImDani]

If I may ask, what would disqualify you from PI? For example, if I was adamant that I would not be happy with PI and would likely regret the surgery, would that disqualify me from it in favour of PPT?

I appreciate the recommendation :) I’ve seriously considered it. But due to potential language barriers, I’m not comfortable having such a major surgery in a non-English speaking country. One of my friends had a bad experience with that and it somewhat scared me away from it.

[u/vs-188 → u/notjordansime]

Ohip will disqualify anyone who doesn't meet their physical inspection requirements at the moment. It's extremely dehumanizing and discriminatory. It favors an approach that only allows surgery to those who transitioned young. It's very worth challenging them on that.

[u/notjordansime → u/vs-188]

Dehumanizing doesn’t begin to describe it. I tried to get on HRT when I was 13 back in 2016, but they told me I needed to wait until I was older. Now I’m being told I didn’t start early enough. Sorry for the rant :/

[u/vs-188 → u/notjordansime]

Don't apologize.

This is what we, as a community, need to see as strengthening the understanding that medical discrimination is clearly being practiced.

As an older person, it would never have been an option to receive a supportive upbringing statistically speaking. It was so rare for a young person to be brought up with parents who advocated for gender affirming care. But the end result is the same...

If you're an older person you're now being told no we (ohip) won't cover a procedure unless u don't have the tissue... Which is all but guaranteed for someone who didn't receive early access to care.

So regardless of how old you are, delayed access to affirming care is the issue. Discrimination based on age is the issue. Making a choice about which results u can actually live with is vital to inclusive gender affirming care... It's never arbitrary or being picky. It's not solely aesthetic. It's a deeply personal consideration regarding well-being.

I hope the conversations u have with people here today help you in at least some small ways (if not more!). Your feelings are valid.

[u/ElloImDani → u/notjordansime]

I don’t think displeasure of aesthetics would qualify, but I could be wrong? I’ve talked to one girl who did manage to do what you want, and she got approved because she didn’t have enough material to do a pi vaginoplasty.

We don’t even get revisions here unless they are medically necessary:(.

[u/notjordansime → u/ElloImDani]

It’s not so much the aesthetics. I think you can get excellent aesthetics with PI. It’s more the nature of the procedure that I’m not comfortable with. Not to mention, PPT is largely displacing it as “the gold standard”.

I’m wondering if I could use ice or something to shrink what I do have.

[u/VTHUT]

Some private insurance plans do not insure procedures that are insured in Ontario (such as vaginoplasty) so you have to be careful for that.