Some Transwomen Are Getting Deadly Discount Surgery. How Can We Help Them Stop?

The New York City Health Department estimates that around 12,500 transgender people live in the city. And not all of them have the $70,000 or the medical insurance to get a safe, medically-approved gender reassignment surgery. So they go to “Pumpers” who illegally provide hormones and silicone injections in their apartments and hotel rooms for a much lower price.

The only problem? Sometimes these Pumpers inject loose silicon, cooking oil or industrial-grade silicone meant for vehicles into these women’s bodies. Often these injections help transwomen look feminine in the short term, but eventually result in disfiguring, calcified clumps that slide down the body that cause intense pain as well as severe illnesses like autoimmune and connective tissue disorders, pulmonary embolism and even death.

The New York Times ran a story about “The High Price of Looking Like a Woman,” but its focus on Pumpers excludes transmen and others who have successfully transitioned.

Nevertheless, it does acknowledge the suffering of transpeople of color disowned from their families who lack proper medical access. It also raises a bigger question: Amid the discussion about what treatments should be customary for trans inmates in custody, what trans-related medical treatments should be uniformly covered as a minimal starting point for medical, clinical, and insurance reform upon which we can build?

The Human Rights Campaign has assembled a great link list to inform LGBT people about trans-phobic medical myths such as “trans procedures are always expensive” and “trans procedures are cosmetic, not medical.” They also have a list of insurers who cover trans medicine. But if more local institutions had a starting point for administering trans medicine, its licensed practitioners might become more numerous and the costs might become more affordable overall.

Part of the answer has to do with visibility. Since trans people still face so much violence, societal disapproval, and exclusion from even the most basic forms of governmental recognition many remain invisible leaving communities ignorant of just how many trans friends and neighbors live in their own towns and just how many would benefit from good medicine and understanding, accepting people.

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  • John

    Not to sound insensitive…but isnt this an example of the thinning of the herd?

  • Daniel Villarreal

    @John: Social Darwinism went out of style in the 1940s, darling. Saying that this is like a “thinning of the herd” is like saying that poverty and disease are “only natural.” Truth is that these tragedies are completely avoidable and poorer, trans-people of color don’t deserve to die from them. To think otherwise is pure ignorant and lethal eugenics.

  • missanthrope


    I don’t think you would be too thrilled with “thinning the herd” if that thinning started with you. Learn to think beyond your own nose for a change.

  • christopher di spirito

    @John: Why all the hate towards Trans folks? Did one of them kick your ass at Pride?

  • John

    Wouldnt you want to kill yourself if you were under the delusion that you were born in the wrong body?

  • Alistair

    Only 12,500 trans in NYC?
    I would have thought that it was more than that.
    With 8 million people and all.

  • milhouse

    Here’s a thought. Why not just turn this whole site over to the “T’s”? It’s all you want to report about anyway.

  • Jillian Weiss

    Note: It doesn’t cost $70,000 to get sex reassignment surgery for MTFs. It’s $20,000 for MTF bottom surgery, which is the essential part for transsexual women. If you need breast augmentation, it’s about $5,000, and if you want facial cosmetic surgery, that’s anywhere between $5,000 and $30,000, depending on what you want done.

  • scott ny'er

    whoa. 70k for the operation. That’s a LOT of money.

  • No One

    Note: $20-50,000 (and the cost of hormones and the cost of changing legal documents) is still a whole lot of full paychecks especially if you didn’t go to law school, have no supportive family members, face discrimination-related trouble staying in school or finding sustainable income, and can only afford to live in the part of town most likely to have a problem with you they feel compelled to take up. More than once that fund will be depleted to help a friend in need or up and move to safety. The cost doesn’t matter, it’s unobtainable.

  • Ginasf

    A correction of Jillian’s numbers… SRS for trans women is between 18K-28K in North America, depending on the surgeon (there are only 6-7 who do it). In Thailand it’s anywhere from 9K to 20K. Facial surgery is between 5K (for a relatively minor procedure) up to over 50K for full FFS by a top surgeon. Breast augmentation is anywhere from 4K to 9K depending on the location of the practitioner and the their rep. Personally, I don’t think the HRC has a lot of experience discussing trans health issues since they regularly give companies a 100% score who offer virtually no trans-based coverage (although they claim they’re changing that in future).

    Which is beside the point for this article because the overwhelming number of trans women who get pumped don’t even have health insurance. Most women in the pumping culture transitioned young, are from ‘minority’ neighborhoods and many (not all) haven’t even finished their secondary education. Some were tormented in high school and dropped out. This is a very complex issue which far transcends trans girls wanting to look sexy and which people in the trans community have been talking about for years but have been largely ignored by those discussing ‘LGBT health issues.’

  • xander

    In addition to ‘backroom’ procedures, “medical tourism” is also gaining ground for GRS, where patients go to hospitals abroad for less costly surgeries. (This is also occuring for organ transplants: kidneys, lungs and livers, btw). Not as risky as the local non-MD practitioners, but more pricey.

    @John: the suicide rate among Trans~ people is several times higher than that of cis-gender LGBs. The suicide rate of lgb teens is also sig. higher than for their hetero peers. What’s your point?–that we/they should just let that happen so as to “thin the herd”? By your reasoning, HIV is also having the same effect. Shame on you for not recognising the pain that others face day to day.

  • Fitz

    I might be missing something, but it seems like an obvious equation.
    People desperate for a procedure that they will never be able to afford
    are obviously going to look for some desperate workaround.

    Any reasonable solution has to include a combo of training up more surgeons, creating laws so that these treatments are covered, and creating economic opportunity (which of course means addressing the discrimination).

    There are lots of groups of desperate people who do dumb ass shit to get what they think they need. People desperate to loose weight are the classic snake-oil customer.

    And as far as Medical Tourism, in general.. it can be done well. Frankly, I had a 50% face lift done 10 years ago in India. It was clean, and the staff was wonderful. And
    I lived like a king for 2 weeks in a hotel.

  • inoits2

    First off WTF is cisgendered?

    The government should treat trans folks just like any disabled person and provide them with the surgery they need to save their lives. Obviously if they have such a need as to inject poisons into their body to achieve the illusion then clearly they have serious mental issues and need help. Just like abortion, it will happen regardless of the law. This is recognized and therefore laws exist to ensure safe abortions. The same should apply to trans in order to provide them with safe treatments.

  • Brad


    Wow! What a truly disgusting thing to say. Would you say the same thing to the parents of gay teen who killed him/herself?

    Callous does not begin to describe how vile your comment is.

  • Samuel

    Technically, transsexualism is listed as a mental disorder. While it does sounds pretty offensive to consider a mental disorder, the fact that it is classified as such and yet treated as a cosmetic decision makes no sense. If they want to classify it as a mental disorder, they need to treat it as one and give these people the care that they need.

  • EmmaMTF

    Fucking idiots. I understand how difficult dysphoria can be, but don’t be so fucking stupid as to try and solicit medical procedures from strangers. Common fucking sense.

  • Drew

    @milhouse: Because despite the trans-related articles Queerty has, its comment sections end up looking like this one.

  • Diego_Rivera_II

    You folks better check out the surgery costs from other sources. I just wouldn’t trust Jillian Weiss without doing my own investigation. (She posts at that dopey Bilerico and was praising that Polaski idiot who tried to equate gay men with the criminal scum of the UK riots).

  • Nice Sean

    @milhouse: LGB people should join the trans fight, I am not trans, but as a bi person, I often feel like a minority within a minority.

    Imagine if we had as little recognition and as much hatred and crime as they have, but wait – a short while ago we did (and in some places, still do)!

    Have we become so short sighted as to our own history that we cannot reach out and help trans people and their poorly publicised plight?

  • Daez

    I will never support forcing insurance companies to provide ELECTIVE surgery. However, there should be a work around. I would also never support forcing doctors to do ELECTIVE surgery. So, I don’t know what that work around is. Perhaps, we should help educate transgendered people to be more comfortable in the bodies they do have. Transgendered identity is absolutely a learned behavior (not a choice, but a learned behavior).

  • SteveC

    12,500 trans people in NYC are trans? That’s only 1 in every 640 people – or 0.156% of the population of New York (and I’d bet the percentage of transfolk in New York in higher than in most US cities.

    Is that accurate?

    If so then I can see why trans people need the LGB community to assist in their fight for acceptance and equality.

    Their numbers are so very, very small.

    I’ve heard the quality of surgery for trans people in Thailand is better than in the US (surgeons are more experienced and plentiful there) and also a lot cheaper.

    I’d recommend anyone wanting an op do their research on the surgeon and their experience (and to bear in mind that Thaliand or India may be a better, cheaper option).

  • Zoe Brain


    I will never support forcing insurance companies to provide ELECTIVE surgery. However, there should be a work around. I would also never support forcing doctors to do ELECTIVE surgery. So, I don’t know what that work around is. Perhaps, we should help educate transgendered people to be more comfortable in the bodies they do have. Transgendered identity is absolutely a learned behavior (not a choice, but a learned behavior).

    ELECTIVE surgery? Here’s what the medical best practices say, the standards of care version 6:
    In persons diagnosed with transsexualism or profound GID, sex reassignment surgery, along with hormone therapy and real-life experience, is a treatment that has proven to be effective. Such a therapeutic regimen, when prescribed or recommended by qualified practitioners, is medically indicated and medically necessary. Sex reassignment is not “experimental,” “investigational,” “elective,” “cosmetic,” or optional in any meaningful sense.

    See where it says, emphasised, “not elective“?

    As for Gender Identity being a “learned behaviour” – maybe this might explain, since you really are clueless here.

    It’s the abstract from Sexual Hormones and the Brain: An Essential Alliance for Sexual Identity and Sexual Orientation Garcia-Falgueras A, Swaab DF Endocr Dev. 2010;17:22-35

    The fetal brain develops during the intrauterine period in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. In this way, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation are programmed or organized into our brain structures when we are still in the womb. However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in extreme cases in trans-sexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no indication that social environment after birth has an effect on gender identity or sexual orientation.

    See the last line? Gender Identity is no more a “learned begaviour” than sexual orientation is.

    The question now arises – why do you say such things? Are you just plain ignorant? Bigoted, so saying “don’t confuse me with the facts”? Or being paid to do this by the AFA or another hate group?

    When it comes to other body modification – facial feminising surgery, augmentation mammoplasty and so on, there’s a good case for calling it preventative medicine. It reduces the chances of fractured skulls, bullet wounds, evisceration, 3rd degree burns etc. Certainly it saves money from treating such illnesses, though not everyone requires it.

  • mike128

    I support the coverage of trans issues on this blog. And I support access to affordable and safe surgical procedures for trans people. Trans people only go to these kinds of providers because other options are not available.

  • Riker

    @Nice Sean: Sure, I’d love to help them. I’ll give them everything I can.

    What I won’t do, though, is sacrifice my own goals for theirs.

  • missanthrope


    No one has asked that of you except for our collective political enemies (republicans, christians and bigots). They’re the ones who are asking people who are saying that trans rights are “a step too far” and be jettisoned for votes or acceptance of cis gay people. Divide and conquer is their strategy, don’t let it work. Rights are not a zero-sum game.

  • Riker

    @missanthrope: If the trans community hadn’t been so aggressive and insistent, we would have had ENDA by now. Trans activists tried to rain on our parade in New York by criticizing us for not devoting resources to passing GENDA instead of the Marriage Equality Act.

    Everytime we both want something, they seem to demand that we put their needs above our own. While I do wholeheartedly support their right to equality under the law, I won’t put my own equality in jeapordy for them.

  • Reality Check

    Commenter Zoe Brain, above, hates gay people and says homosexuality “should be discouraged”.
    On his blog he said two gay men getting married makes him -sorry, “her” – want to puke.

  • Sweetbrandigirl2004

    @Zoe Brain: Do you see were it say’s “transsexualism” ? The standards of care are intended for Transsexuals NOT Transgender wannabes who self diagnosis and self medicate. EVERYONE needs to make sure they are clear in when they talk about Trans” people that they distinguish between whom they are referring as there are HUGE differences between Transsexuals AND Transgender.

  • Carson

    Finally. Great post, Villarreal. You did a great job with this post and bringing attention to this problem. And for all the LGB people bashing T people, FUCK OFF. No, I’m not trans. Just not an ignorant narcissistic bastard.

Comments are closed.