The High Cost Of Living

Recently, I finally got a court order from the County of San Francisco to update my birth certificate. That was $480 plus a decent amount of time. Then I dropped that, more paperwork, a certified copy of my legal name change (another $400+ piece of paper) and another $22 in the mail, shipping it off to the Commonwealth of Virginia. By early September, I should have an updated birth certificate. Then I can get a passport and an updated California driver’s license. Never mind that my Minnesota license is already correct, California wants some different paperwork and my license expires on my next birthday. Sometimes I wonder, how much did it truly cost? 

It’s a trickier question than you might think. Let start with what I needed to update the birth certificate. I am able to update it because I have a vagina and that’s what the state I was born in requires. Seems a bit arbitrary, no? And I have that because my insurance was so kind as to cover my “sex transformation” (as they put it. No. Really) as long as I had all my paperwork in order. I paid my deductible ($2,000) plus some other incidentals since unfortunately I didn’t live 20 miles from San Mateo like I do now (probably another $2,000 or so with travel and hotels). I was out of work for a while after that, too, though thankfully FMLA came through for me on that, but that’s not a given. That vagina requires some minor maintenance, and will forever, but there’s worse fates that dilating, and that’s a fairly minor cost, all things considered, but it’s nonetheless a little time and money, so consider a few bucks every month or so for that as well. Prior to that, I paid about another $500 to make a consult happen. I didn’t need it as much as I needed peace of mind it provided. That, of course, is just my experience. Costs vary wildly, from upwards of $20-25k to others who’ve had similar experiences to me.

Now in order to get insurance to cover the procedure in the first place, I needed two letters from doctors. I had good insurance and lived in the Twin Cities where such a thing was less of a hassle but it’s still a hassle. Now to get those letters takes a while because there’s a degree of time required before they will give them to you. The gist is usually that you are “full-time” (which is a ridiculous term, but bear with me, there’s a lot of ridiculous jargon when you go through the front doors of the gatekeeping process like I did) for two years, which means you are living in your chosen (read: actual) gender for at least two years prior to surgery. Or maybe it’s only one? Either way, the gatekeeping process doesn’t exactly have a vested interest in pushing you along (you’re paying the bills after all). I always felt I was marking time. At best, that’s a few years meeting with doctors. Pretty frequently. Again, fortunate to have good insurance, but even with a decent co-pay I was probably spending a good $60-70 a month. Without it, it would have easily been double. Or not possible. Getting insurance to cover it in the first place was a whole to-do as well, though that only cost me time in the end. Ignoring that, that’s still conservatively about $3,000 over four years or so.

Medications don’t come cheap either. Well, spironolactone wasn’t that expensive, $5 or so, but estradiol, even when covered, ran me $28-35 for eight patches. And you have to take more estradiol at the beginning because you still have all this damn testosterone. So it was two patches twice weekly until miracle of miracles it’s no more spiro and half as much estradiol. Now through some strange act of fortune, even my estradiol is generic (all praise $7 meds) but drug prices always bounce around and it’s not given it’ll stay that way. I’m not here to project, though. I started medically transitioning in May of 2008 at which point I was probably spending about $60-70 a month on meds; after surgery that dropped significantly, but until recently I was still spending $30-35 a month, roughly. Let’s say I’ve probably spent $3,500 or so on meds the past 7 years. Pre-tax fund because, again, I won the insurance lottery.

There are lots of other things too. I never had much facial hair, and it’s nice and dark and I have fair skin, so I only had to pay for several sessions of someone shooting my face with lasers. Is that required? No, but I am guessing you’d have a hard time finding trans women who haven’t had at least some who transitioned after puberty, provided they can afford to, because facial hair is hella triggery for pretty much anyone I’ve met, though I’m sure some people care less than others. That can range wildly in price, but I would say it’s probably another $2,000 that I spent. And if you are going to have GRS, at least the doctor I went through wanted me to get some laser on my groin area as well. Again, probably spending $3,000-4,000 on that all told by the time it’s all said and done. At least. And while you might not care that much, if you are going through the traditional gatekeeping process (its own bullshit topic for another day), your doctor might. Hopefully that is getting better, but there’s a certain amount of performative femininity required when dealing with people like that. And sure, it seems stupid, but if you weren’t getting laser, they might wonder if you really want to be yourself. Which, again, is ridiculous, but these are the kind of people you’re dealing with and they wield an outsize influence on your life.

And of course, as a trans woman, welcome to the higher incidental cost of everyone giving a fuck about how you look. And with the trans component, welcome to the additional balance of trying to be yourself in a world where many might say too much femininity is just buying into toxic standards for women and not enough is you not trying hard enough as a woman. If they think of you as a woman at all. This is ignoring, of course, that maybe you wanted to do these things for a long time, but you felt constrained by the narrow norms of being socialized male in our society. There are still higher incidental expenses for women in terms of personal care. We can want that to get better and change and still acknowledge that it exists. Plus it’s an exciting time of trying to do all these things that you may have felt you couldn’t do openly before. I certainly spend more on my personal grooming now than I did before, because I want to. No one is making me. My hair doesn’t stay this color on its own, though. This is much harder to put a price on, because much of it just stems from how much more I care about how I look now because I finally look like me and that’s worth spending money on. Still, that cost is there to a degree.

By now, hopefully you are beginning to see how paradoxically interconnected it is. It helps to have a good job and good insurance, but it can be hard to get a job when your legal documentation doesn’t match your actual identity. And it can be hard to update that legal documentation without a job. You may have to out yourself in the process of employment because of that, or in an attempt to determine whether or not you will get sufficient medical coverage, even if you have no desire to be out to your employer. And even if you have a decent job at the start of actually transitioning, who knows what might happen? Financially speaking, there’s a good chance your wages will stagnate or go down even if you are the exact same employee you were before. You might even be better now that you can bring your authentic self to work, but that’s no guarantee you won’t find yourself on the way out soon enough. And there could be whole new problems that come up and make the job untenable. Then what? How much is enough? How do we justify that to ourselves? What bargains are you going to make to be yourself after a life of already making lots of bargains to not be yourself? It sure is satisfying to say none, but that is a difficult path.

Can you put a cost on truly being yourself? No, but is there a cost? Definitely. Not just in the money that you have to spend, but in how society will treat you. Even in my life where things have worked out well, it’s hard not to wonder if my male coworkers doing the same job as me are making much more (probably), if they have a better chance to move up to whatever’s next (also probably). I am sure they feel more comfortable taking chances. I do now, but there was definitely a time when I couldn’t afford to, lest my insurance change. Which is still a privilege, of course. That I have good coverage at all puts me in a different category. But it’s still a tenuous relationship. Luckily I haven’t felt stuck at a bad job because of it. But since that isn’t a given, that was a cost I had to keep in mind. It is better than having nothing at all. And we should address that as a society. But you can see how it affects how you think of things, no? Better doesn’t mean it’s as good as it should be if we’re talking overall goals. There are more important people to reach first than me. But like most things in life, it’s not a simple linear progression. We can simultaneously be working to make this better, but we should keep in mind that circumstances are statistically much worse when factoring in race, class, education.  Hell, I experience it because I’m a woman and our systems are much better equipped to handle binary than non-binary folks. I may be trans, but I still experience a lot of privilege because of who I am in other ways. Lots of folks can’t just sit down and tick off the costs they’ve paid for stuff like this because they don’t have the money, insurance, and access or the systems aren’t set up for them in the first place and we aren’t doing enough to ensure that they enjoy those things.

Soon, I’ll have paid the last simple, pecuniary costs of my transition. Really, I already have in that things like new IDs and passports are incidental costs we all pay going forward as we get older. I never feel like I’m done in the sense that I’m always trying to be more me, and I already largely feel I closed that initial chapter years ago. This is more of an epilogue or an afterward. One last thing to do before a checklist I laid out many years ago is done, really, truly finished. Even if I thought I could, it’s hard to put a number on it, but it’s easy to see the costs are too high.

It’s Something You Learn

It’s Something You Learn

“I’d love to see that beautiful mouth on my dick.”

You think about what you would say in those situations

will all that verve telling him to go fuck himself, though

it’s difficult in the moment to actually say those words.

But it’s something you learn to say because

tonight it might be the corner of 18th and Van Ness,

tomorrow it might be at someone sidling up as you order a Racer 5

or waiting at 16th and Mission to catch the next BART,

hell, it could even be someone swinging by your cube.

But it’s something you learning to say because

it’s important to call out that kind of behavior,

to put the onus back on back on them,

after all, it’s something you learn to say.

In The Right Place

Pull out a fresh towel,

wipe down the plate,

one, two, three times,

top left cabinet, middle shelf,

grab the next one,

until the rack is empty.


There’s still (always) a full sink,

so run the water, pour in soap.

My parents probably wonder

where this person was years ago.

I do too, but it’s not like

anyone else is here to do them.


Besides there’s simple pleasure in

taking care of what I can,

right in front of me, making sure

everything is in the right place,

ready to go the next time I bake

cookies at midnight on a whim.


The bubbles are poised,

ready to attack.

So shut off the water,

drop the dishes in,

grab a sponge and

start scrubbing again.

Most Mornings

Most mornings I lie in bed,

awake before the alarm goes off

after eight years of 9-5s.

I reach for my phone,

(who doesn’t these days?)

nothing urgent, just reminders

of what I need to do today,

only half of which I’ll get done.


Most mornings I lie in bed

for a few more moments,

trying to determine whether I need

to slow down to take care of myself

or push myself to keep doing more

even when I don’t totally feel like it

but if the former were true,

I’d rarely get out of bed.


Most mornings I lie in bed

for those last few moments

wondering when two beers became too much

but there’s no time for that.

I cannot continue to lie

in bed, so I swing my feet over, sit up,

and promise myself an early night.

Me Looking Back

Was I really living before I had a brow lady?

I wonder as I arch my eyebrows in the mirror

I mean, really? This coming from the girl

who rarely makes time for make-up

with hair that insouciantly lives up in a clip.

But even those looks are practiced, looking like you look

like you don’t care is a look too, after all.

Perhaps I’m overthinking it, caring about how I look

still feels novel even if it’s not that new, besides

it’s really more about me liking how I look.

It took me a long time to learn to like the me looking back.

The Price I Pay

The Price I Pay

480 dollars

for a piece of paper from the county of San Francisco

along with another piece of paper I paid Hennepin County

400 dollars

for just so I can pay the Commonwealth of Virginia another

22 dollars

for yet another piece of paper to finally update two more pieces of paper for

168 dollars,

altogether a fraction of what I’ve spent over the years if I really did the math.

Some might say with all this money, I’m just papering over my old self,

though I am not trying to hide anything, just the opposite really,

no one asked me what I thought all these pieces of paper should say in the first place,

so this is just one of the many prices I continue to pay.



All this talk of San Francisco running out of space

feels so distant when you’re driving down the 5

over rolling hills, between fertile and fallow fields.

Just almonds and alfalfa, cars and cows, the occasional town.

Even in this discrete place we call The City,

I’m surprised by how many empty lots I see riding

through the Mission, how many dilapidated homes I find

wandering out Geary toward Land’s End, where I go to look

at a 75 year old bridge that continues to captivate so many like me,

surrounded by trees planted by those who tamed these

western dunes not that many years before that.

The trees, the buildings, the people, we were all once

transplants competing for a foothold, and I think if we look,

we’ll find there’s still space for us all to grow,

even in this discrete place we call The City.

I Never Will

That’s a clever announcement on Facebook

followed by the inevitable “boy or girl?”

As if those are the only options. 

As if you need to know. 

No one ever waits to ask

the person who could tell them best.

It’s a question I’d never presume to ask,

never presume to know.

I’d never want to find out

but I never will.


Do you remember a time when you weren’t you? Never mind, that’s a paradoxical question. You are always you and yet you were never this you. And you won’t be ever again. Perhaps a more honest way to ask that question is this: do you ever remember a time when you lacked the tools to lessen the distance between who you were and who the world around you perceived you as? Do you remember a time when the dissonance that caused was all that you could truly hear? Because I do. Coming out as a transgender woman didn’t change who I was; whoever she was, whoever she is, who she will be, they’re all me. Coming out and accepting myself for who I was simply signified the start of trying to live a more fully realized, harmonious life. I have always been myself; now I am just more myself.

Sometimes it’s hard to believe it’s been seven years since I made the most demonstrable efforts to be who I am. My life is not perfect, but perfection is Barmecidal. I have enough to satisfy my basic needs, and many of my wants, and that is more than many, and more than enough. I also had an easier starting point than many, not through anything I did in particular. If I have learned anything in the past seven years it’s been that. Life doesn’t work out for a lot of trans folks. Not through any fault of theirs. It’s easy to find the near-constant reminders of how society views us and how society treats us. So being with the same company for eight years where being trans does not hinder me professionally is a big thing. That also makes me an outlier. At least based on what I see statistically about what I hear anecdotally. That’s just one example of ways society needs to change and get better for trans folks. I’d like to think change is like a fault line, splitting open after so much pressure, causing great upheaval, but change can also be like erosion, slow, so slow you don’t even notice it at times. Both kinds work, and I’d like to shake things up more, but I can also slowly help carve out a place that many people slowly helped carve out before me too. They aren’t mutually exclusive ways of trying to make things better for those who are yet to come.

For a long time I thought there were things I had to do better; certainly I can be better as a person, but that does not mean I have to make anyone comfortable with my transness. I am neither required to make myself seem more cis nor immediately declare my transness to make you aware if you weren’t. The transphobia of others is not my fault. Yet it’s still my problem. It’s why I can still be fired in 32 states just for walking through the door as myself; it’s why GRS is required to update my birth certificate because that means I’m sufficiently trans enough for the Commonwealth of Virginia to deign to recognize me as female and I am lucky to even be able to do that; that’s why I’ve had people shout out me on the streets that they ought to kick my ass for impersonating a woman. All for having the audacity to get up and walk out the door every morning as myself after not having done so for the first 27 years.  Being trans doesn’t involve anyone being a certain way other than being their most authentic self.

Living like that instills you with a sense of furtiveness if you can manage it. I have never been terribly successful at it, but I have learned when the time and place is. Being trans has no bearing on a trip to Safeway, so it’s not like I’d bring it up. Until the cashier calls me sir. Then it becomes an issue. Then I have to decide whether to correct the cashier even though it’s not my job to educate others on demand. Then I have to decide whether it’s even worth it, because I’ll be frustrated either way and so many people are not worth the time. I don’t necessarily intend to center everything in my existence on my transness. But how can I not? I see how the world perceives me on a near-daily basis. I’ve seen that look countless times when I walk into public restrooms, when I’m trying on a dress, when I’m getting change at a register. Even if I am a more open person, I rarely let my guard down in regard to taking care of and looking out for myself. How can you blame me? Even if I’m fortunate, I’m still trans in a world that largely despises trans people. Most people I encounter aren’t overtly transphobic, but like any form of discrimination, it’s a folly to think of transphobia as only direct actions. It lurks in so many places.

Most trans folk may not be lucky when it comes to how we are treated. But we are fortunate in that we know ourselves. We have been forced to interrogate what makes us who we are. I am lucky that I found myself in a world that does not go out of its way to support my existence. I am lucky to live a more fully realized life, a much more examined one, at least. Not because I’m smarter or better or anything, just because I had to figure it out. I had to decide. Did I want to be who everyone wanted me to be, or who I wanted to be? I don’t blame anyone for looking around and feeling like they can’t do that based on how our society currently is, especially if they’re trans. We need to make a more accepting, supportive world for people to interrogate who they are. Because everyone should be able to do that. Everyone should get to be who they are, not who they’re told to be. My lived experience defies what I was told was possible for so many years. Hopefully, just living my life every day can be a small demonstration of that. I am always in the process of trying to become more me. Perhaps I can help set an example or do something to help you in the same regard. That difference does not feel as large as it did seven years ago, when I really truly began the process of being myself, fully, without shame or regret. But there are always things I can do better. If I’ve got mine, the least I can do is something to help everyone else get theirs too. My experiences should be the baseline, not the exception.

My life is full of so many great people, and I have much better relationships with you now than I ever thought I would just by virtue of being myself, of being fully present. So, to everyone out there, wherever I met you along the way, whether it was just recently or years ago in high school, thanks for being there. I cannot stress how great it is to have so many supportive people in my life, people who continue to challenge themselves and grow just as I try to do the same every day. I do not take any of that for granted. I am lucky to call you friends, to know there are a great many people who support me, who do want a better world for trans folks. I look forward to whatever’s next and I can’t think of a better group of people to discover that with.

April 17, 1906

There’s a certain sense of doom that hangs over San Francisco. You see it when you look around and see so little from before 1906. Or the eastern span of the Bay Bridge. Or Hayes Valley. Or West Oakland. I’m constantly aware of that, living here. How could you not be? We don’t know when the next big one is coming, but we do know it’s coming and no matter what, we don’t truly know what it’s going to do. And while it’s doubtful we’d see something on the scale of April 18, 1906, it’s important to remember how little we truly know. I don’t think anyone went to bed on April 17, 1906 expecting much of the city they called home to lay in ruins the night after. We may be more aware, we may be more prepared, we may have better tools to deal with whatever comes next. But we may not. And it’s arrogant to forget that. We may be cavalier, joking about how the next big one will drive down housing costs, and we may put together our emergency kits and go over our evacuations drills at work. We do that to be ready, but we won’t truly know what it’s like, or how to act until it happens. The repetition of things beforehand? That is so we don’t have to think about what to do and we can just act.

San Francisco is undoubtedly an amazing place to call home. I consider myself fortunate to be able to. I never get tired of the views, of the ocean, or the bridges, or the characters that populate this place. At least, those that remain. But when people ask, am I telling them or reassuring myself? Am I in a bad relationship with the city I call home? Is this really a good place for me? Is this really a good place for anyone? But then you turn the block, look out over Outer Richmond, and catch the tops of Golden Gate and remember. You see the city from Alameda and it looks like a mirage. Perhaps it is. It certainly doesn’t feel like a real place at times. This city has you questioning why you live here and remembering why you love it in the span of one block. It might not be as foggy as they tell me it used to be, but the city still has an ethereal quality, blanketed in fog, with fog horns for white noise some nights if you live in Inner Richmond like me. If I keep telling myself how wonderful it is, perhaps I will believe it too.

I’m about to begin my third year here. It feels like half the people I’ve met have already moved or will be moving soon, half I barely see. It feels like I haven’t met that many people at all. Every year, it gets just a little bit more taxing to try to get to the shows I want to go to and make everything else work. Living by yourself is great, but I spend more time alone than you probably realize, though we have technology that ameliorates that these days at least. I love San Francisco, but city has its own problems, deep, creaking faults beneath its superficial charms. It feels like those things are never going to change, not when we have people seriously considering the idea of a moratorium on market-rate housing in the Mission, not as we continue to fight over a few street parking spaces that get in the way of making biking much more appealing and safe on Polk Street, not as we idly dream of a second trans-bay tube that’s 30 years away at best if it happens at all. Besides, I am not getting any younger, and my priorities as an individual shift as well. It isn’t just a pecuniary consideration. At what point does this city no longer have enough to hold me? At what point is the cost of living here too high beyond the rent?

As I begin my third year, I wonder if that would be better anywhere. Many of my issues are not place-specific. I feel constant stress about changing anything in my life, and you might too if you are trans and you are in a good situation in a lot of ways. I have found the thirties somewhat trying as my life has diverged from many of my friends because I do not have kids and I still like to go out on a Tuesday night. I had those same problems in Saint Paul, too. As much as I love San Francisco, it cannot solve problems like that. This is one of the best places for me to be professionally. But I still wonder, is it the big one I should worry about? Or is it all the little shifts that are constantly happening that I don’t notice as much? It’s not the earthquake you have to worry about anymore, it’s the notice of rent increase from your landlord, the eviction that turns your place into an Airbnb, the loss of any amount of income that allows most of us to maintain the tenuous balance we call living here, the loss of friends that help make a place something more than coordinates. Most of us aren’t prepared for that, no matter how much we’d like to think it. Every day here feels like it’s April 17, 1906. Until suddenly it’s April 18, 1906.

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