How much does hormone replacement therapy (HRT) cost?
Hormone replacement therapy (HRT), also known as hormone therapy or sometimes transgender hormone therapy, refers to the administration of hormones for those whose bodies do not produce adequate amounts. The goal of HRT is to supplement hormone levels to match the average levels produced by the desired gender.
There are a variety of factors that influence the cost of HRT:
- Type of hormones - The main hormone medications used in HRT include:
- Estrogen - Used in transfeminine HRT to develop feminine secondary sexual characteristics. Available in pills, patches, gels/creams, and injections.
- Testosterone - Used in transmasculine HRT to develop masculine secondary sexual characteristics. Mostly available as injections or gels/creams.
- Anti-androgens - Used to block testosterone. Often part of transfeminine HRT regimens.
- Dosage and delivery method - Hormones are available in different doses and delivery methods like pills, patches, gels/creams, and injections. Injections tend to be more expensive upfront but may be cheaper over time.
- Insurance coverage - Those with health insurance that covers transgender care will pay less out-of-pocket than those paying the full cash price. But coverage varies widely.
- Location and clinic - Prices can vary dramatically depending on country/state and specific clinic. Clinics aimed at low-income patients may charge below-average rates.
Average costs:
While exact HRT expenses vary drastically, below are very rough national averages for the United States:
- Transfeminine (MTF) HRT:
- Oral estrogen anti-androgens: $30-$100 per month
- Estradiol injections oral anti-androgens: $100-$300 per month
- Transmasculine (FTM) HRT:
- Testosterone gel/cream: $100-$300 per month
- Sustanon/cypionate injections: $75-$150 per shot (typically 1 shot every 2-3 weeks)
Of course, costs can be higher or lower depending on local prices, insurance coverage, specific medications prescribed, and dosage needed for desired effects. Below are some additional cost considerations:
- Initial doctor visits & lab tests:
- Expect to pay $$$ for an initial doctor consultation, blood tests, review of results, and prescription. Follow-ups are cheaper.
- Supportive care & monitoring:
- Ongoing doctor visits and lab tests are recommended to monitor hormone levels and health markers. This adds more $$$ in costs.
- Other medications:
- Those on estrogen may take supplements like biotin, finasteride, spironolactone and progesterone which have additional costs.
- Surgery:
- Top/bottom surgery required for complete medical transition also costs $$$$$. Expect expenses of $10k in most cases.
Lowering costs:
Here are some tips for lowering HRT expenses if paying out-of-pocket:
- Use GoodRx coupons for oral medications
- Buy injectable hormones in bulk via online pharmacies
- Use longer-acting injections to reduce frequency
- Get generics instead of brand name if possible
- Use patient assistance resources from manufacturers
- Shop around between local pharmacies & clinics for best pricing
- Switch to pills, patches or gels instead of injections
- Pay attention to insurance formulary tiers and changes
I hope this breakdown gives you a better idea of the average costs associated with hormone replacement therapy. While not cheap, most transgender individuals who medically transition view the costs as worthwhile given the dramatic positive impact on their mental health, quality of life and congruence between gender identity and physical characteristics. Please let me know if you have any other questions!