Blog — Sisters for Financial Independence (2024)

Medical Costs / Health Insurance

As someone that is heterosexual cisgender woman, my concerns with medical costs dwindle down to my employer’s health insurance plan and knowing that I can probably receive coverage for a myriad of issues. However, the LGTBQ community can face other health care concerns that can put a hole in your pocket on top of navigating the complicated healthcare system. Here a variety of medical expenses that may be an additional cost:

Gender-affirming Care or Transgender Costs

Gender-affirming care (from surgery, hormone therapy,, and more) can be pertinent to how a person may align their bodies with their respective gender identity. Oftentimes, health care associated with gender transition is often interpreted as cosmetic, resulting in many insurance companies not covering them. Trans-related surgeries can cost thousands of dollars, so gaps in insurance coverage leave much of the LGBTQ+ community with minimal options -- either face the financial brunt and debt or forego treatment that can exacerbate gender dysmorphia. Getting the right care can help reduce the emotional distress of gender dysmorphia, but many individuals simply cannot get treated because they cannot afford it (BusinessInsider). Not having the financial means or support to go through with medical procedures presents a huge risk to individuals. Some examples of medical costs could include hormone replacement therapy (HRT), breast augmentation, bilateral mastectomy, facial feminization or masculinization.

HIV Treatment

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system and if not treated can lead to AIDS (acquired immunodeficiency syndrome). Reducing the risk of HIV transmission is very important. Contrary to the stigma and misinformation widespread in the 1980s, HIV cannot be transmitted by air or water; saliva, sweat, kissing; insects; and sharing food or drinks. In short, for those at risk for HIV, an individual should seek pre-exposure prophylaxis (PrEP) (CDC). If one does have HIV, they can receive care via antiretroviral therapy (ART). Like other ongoing treatment and care, it can be quite expensive, especially without insurance.

Mental Health Costs

It is no surprise that getting the right care for one’s mental health can be an additional expense in one’s wallet. Not only does one have to find the right therapist that fits the needs of an LGBTQ+ individual in the first place, but they also need to navigate the costs of obtaining mental health resources. Many workplace policies and benefits packages are still in the process of developing worthwhile resources and programs regarding mental wellness.

Lifestyle Costs

Individuals may feel more comfortable living their true selves in more progressive areas or cities, but often these cities come with a higher cost of living. As a result, LGBTQ+ individuals may have to deal with higher lifestyle costs as a result of their sexual orientation or gender identity.

There are additional lifestyle costs that can come associated with living in a city, but there are also other personal costs that can leave a hole in your pocket. For example, another lifestyle cost could be associated with gender-affirming care, like the idea of having to buy a new wardrobe to fit one’s gender identity. New clothes for after surgery or in general can be costly. Buying makeup, getting your hair done, or hair removal can also be expensive. These are just a few instances of other costs that could build up.

Estate Planning

Estate planning is the preparation of steps to take once you pass away, including instructions on what you want to pass on, who you want to give it to, and when someone should receive it. It’s not an easy discussion, but a pertinent one to have to figure out your financial affairs ahead of time. It’s not just for retirees, as we will never know what day will be our last. Good estate planning helps minimize the loss of time and assets and eliminates confusion. Having a will or living trust helps organize beneficiary designations. So why does the LGBTQ+ community have a particular concern with estate planning?

While estate planning is for everyone, it can become complicated very quickly. “Obergefell v. Hodges, .. “A Pew Research Survey shows that four in ten LGBTQ+ adults have been rejected by a close family member or friend due to their sexual orientation, which can have ramifications on their estate planning.” This means that same-sex couples’ estate plans could be more susceptible to damage by unsupportive family members - from having their wills contested to custody battles over non-biological children (Wealth Enhancement Group).

Workplace and Housing Policies

hom*ophobia and discrimination policies are still a major factor in where individuals may choose to live, work, and even retire, says David Rae, a certified financial planner in Los Angeles who serves LGBT clients (Creditcard.com). Something that many heterosexual or cisgender individals take for granted is how their employer may view them in the workplace on the basis of their sexual orientation or gender identity. Discrimination in the workplace can result in high unemployment rates for the LGBTQ+ community. While there are many states that protect workers by local laws, there are still many states that do not provide full protection from discrimination. The Equality Act amends the existing Civil Rights Act of 1964 to include additional non-discrimination policies for LGBTQ+ people but it has unfortunately been up in the air - as conservative values, religious exemptions, ministrial exemptions muddy political decisions (Human Rights Campaign). Workplace uncertainty poses a huge risk for LGBTQ+ individuals, as job security contributes to our physical, mental, and financial wellbeing.