My word, how many Red Herrings are there in this school if fishy ideas?

Let's see, an act about Employment Discrimination has been (deliberately?) confused with issues of health care and even the ethics of treating those with apetemnophilia (Google it).

OK, some facts addressing some of the peripheral questions:

1. Cost of SRS

i) Sex reassignment surgery - for the individual, $15k to $120k. 15k from a reputable Thai surgeon, providing the patient isn't intersexed, and a normal penile inversion can be used. US and Canadian surgeons cost more, up to double. For FtoMs, a 12-stage procedure involving many operations over many years costs on the order of $100k or up. That only has a 30% success rate, though less complete surgeries can cost a third as much, and have very high success rates. About 1/3 of all operations have complications, ranging from mild to fatal. Usually mild.

ii) Cost of SRS - from a health insurance viewpoint - in California, the Health Insurers started charging $1.18 extra per month, based on pessimistic assumptions. Actual measured cost is now determined to be 2c/month.

iii) Cost of Transition - to look unremarkable, most older MtoFs need FFS - facial feminisation surgery. That's not to look pretty, it's so they don't get beaten up if walking past schools. Cost of that - $20k to $40k. Then there's the necessary electrolysis to get rid of facial hair. 400 hours at $40-$150 an hour. Call it $25k on average. Then there's the hormones, the required visits to shrinks (some of whom charge $200/hour and up) and so on. Boob Job and hair transplants if needed (they usually are). Speech therapy too.

In my case - $15k copayments for medical tests (I'm Intersexed in a weird way, 1 in several million). $3k and climbing for IPL and electro hair removal - the IPL did wonders, but it will take several years and $10k to get the remnants. $20k for the Genital surgery (SRS equivalent). I can get by without FFS, but it would be nice to look normal. Same with AM - Augmentation Mammoplasty. Nice, but not needed to avoid danger. $3000 copayments for Psych ($250/hr) and Endo (likewise). $1000 for my GP. Another $1500 for OB/GYN as the genital rearrangement surgery (can't call it SRS as I was medically female beforehand) had complications. None of this tax deductible, and the costs are copayments after insurance. Most isn't covered at all.

2. Rate - the traditional rate based on 1960s data from Europe is 1 in 30,000 women, 1 in 10,000 men. So a total of 5000 women and 1700 men in the US. 500 and 170 born every year, if these official figures are correct.

The measured annual rate of surgeries in the US is 500-1000, and of US citizens in Thailand alone, another 1000 per year. This has been the case since the 80's, and so there are around 50,000 women "with a past" in the US, the majority of them "stealth". 10 times the official rate.

Why there should be such under-reporting is a good question.

Source:

http://ai.eecs.umich.edu/people/conway/TS/TSprevalence.html

Correction : 1 in 100,000 men, not 1 in 10,000, is the official figure. A typo.

And a clarification: "woman" in this case means "person with female-pattern hyptholamic stuctures and limbic cortex born with a male, mostly male, or apparently male body". The dividing line gets blurred, as many who are neurologically intersexed (ie have Harry Benjamins Syndrome aka HBS aka Transsexuality) are intersexed in other ways too.

For a full explanation, medical papers, autopsy results, fMRT scan results etc etc see TS 101 at http://aebrain.blogspot.com/2007/10/ts-101.html

Some other figures:

30% of TS people who aren't treated suicide (California Survey)

90% of TS people who don't get treated die prematurely, from suicide, murder, substance abuse, being refused medical treatment, or STDs (West Australia survey)

50% of TS people under 20 self harm (vice 25% for GLB) - Scottish Office Survey of Northern Ireland, the most scientifically rigorous of any of the figures.

70% of TS people suffer "significant employment discrimination"

50% of TS people have been fired at least once for being TS

75% of TS people in California are not in full-time work

The median income for TS people is ~ $15,000. This is why so many cannot afford surgery.

In a "straw poll" at a TS support site last week, 1/3 of post-operative TS women reported they were always attracted to men. 1/3 reported being always attracted to women, and 1/3 reported sexual orientation changing from lesbian to straight. The incidence and degree of bisexuality was not recorded, but believed to be high. This is consistent with more rigorous figures gathered by Lawrence et al.

See http://aebrain.blogspot.com/2007/01/statistics-and-sex-changing.html