Healthcare Cost

How Much Does Gender-Affirming Hormone Replacement Therapy (HRT) Cost without Health Insurance?

Sophie Wei
Sophie Wei27 Jun 2022

On average, hormone replacement therapy (HRT) for gender affirmation can cost anywhere from $30-$100 a month for individuals without health insurance. The World Professional Association for Transgender Health (WPATH) also suggests that you receive a formal consultation with a mental health professional, which can cost anywhere between $75-$200 without insurance. 

Costs of Gender-Affirming Hormone Replacement Therapy 

The amount you pay for hormone replacement therapy will depend on several factors, including prescribed medications, your consultation with a mental health professional, and your insurance status. Below, we break down the costs associated with each of these factors. 

How much do Hormone Replacement Therapy (HRT) prescription medications cost?

The costs of HRT prescription medications can vary drastically depending on the dosage form, your prescribed dosing regimen, and your insurance status. It is important to speak with your healthcare provider to find the dosage and formulation of HRT that are the best fit for you. The following charts list the possible ranges of costs for both testosterone HRT and estrogen HRT based on the dosage form and day supply.

Testosterone HRT Prescription Costs 

Formulation Dosage SupplyPrice 
Gel Pump88g of 1.62% gel 30 day supply$127.55 - $130.55
Topical Solution 30 mg/1.5 mL in 90 mL bottle 30 day supply$149.40 
Packets 30 packets, 50 mg each 30 day supply $127.15 
Testosterone Cypionate Injection 4 vials, 200mg/mL, 1 mL each 8 weeks $24.32 
Testosterone Enanthate 1 vial, 200 mg/mL, 5 mL 10 weeks $32.28 

Estrogen HRT Prescription Costs 

Formulation Dosage SupplyPrice 
Estradiol Carton1 carton of 8 patches (.05 mg/day) 4 weeks $37.05 
Estradiol Tablets 90 tablets, 1 mg each22-30 day supply $19.95 
Estradiol Valerate Injection 20 mg/mL (1 5mL vial) 25-50 day supply $46.75 - $49.75 
Estradiol Cypionate1 5mL vial (5mg/mL) 2 week supply $143.09 - $146.09

Note: these are average prices of various prescriptions used for HRT, but the price you pay may differ from the prices displayed in the charts above. The prices displayed in these charts are based on prices listed by GoodRx for typical HRT maintenance regimens; however, the regimen prescribed to you might differ based on your needs and your provider’s approach. The data above is also based on medication costs at CVS pharmacy and might vary if you go to a different pharmacy. 

How Much Do HRT consultations Cost?

In most instances, before you can obtain a prescription for HRT for gender affirmation, your physician will require that you obtain a referral letter from a mental health professional. According to the World Professional Association for Transgender Health (WPATH), this letter is a recommended practice that indicates that you have been properly assessed and are ready to begin HRT. To obtain this letter, you will have to undergo a formal consultation with a trained therapist or mental health professional. 

According to WPATH, these letters typically need to include: 

  • Patient characteristics
  • Results from patient assessment
  • Duration of interaction between the patient and the mental health professional
  • Medical rationale for receiving HRT
  • Proof that informed consent was obtained from the patient
  • Availability of healthcare professional for a coordination of care meeting

The costs of these consultations will vary based on the facility; however, on average, therapy sessions in 2022 can cost anywhere between $75-$200 to meet with a psychologist if paying without insurance.  

It is important to note that some facilities, such as Planned Parenthood, do not require a letter to begin hormone therapy at one of their health centers. Additionally, when choosing a provider for consultation, be sure to look out for LGBTQ+ friendly doctors to ensure that your experience is safe and that you receive the best care possible. 

HRT Insurance Coverage 

Private insurance companies have different guidelines regarding their coverage for hormone replacement therapy. However, it is crucial to know your rights regarding insurance coverage. Federal and state laws both mandate that health plans cannot exclude transition-related care from their coverage or place limits on your HRT coverage. However, your insurance company can still require that you provide medical evidence from your healthcare provider to show that your transition-related health needs are medically supported. 

The documentation requirements from private health insurance companies can differ based on their policies. If you are already insured, check your member handbook or call your health insurance provider to understand all the requirements. If you are not insured but are looking to become insured, the following link is an excellent resource to view various health insurance companies’ respective medical policies around gender-affirming procedures. 

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HRT Medicare coverage

Medicare is a government health program that can be a vital resource for HRT coverage. If you qualify for Medicare, your hormone therapy can be covered by Medicare Part D, as HRT is considered a prescription medication. However, Medicare guidelines for transition-related care can differ on a state-to-state basis. 

Use the following link to see your state guidelines for HRT Medicare coverage. For reference, the Medicare monthly premium in 2022 was $170.10. Your Part D costs will include your monthly premium and may change based on your annual income and tax returns. Utilize this document to see how your Medicare costs might vary. 

Gender-Affirming Hormone Replacement Therapy Financial Assistance

Being able to pay for HRT for gender affirmation without insurance can be a difficult task. If you find that you do not qualify for Medicare and are uninsured, the following organizations may be able to assist you financially. 

Point of Pride 

Point of Pride is an organization dedicated to providing financial assistance to transgender individuals for health-related needs. In particular, their HRT Access Fund provides you with 12 months of free medical care. As long as you meet their requirements and fill out their application process, you will be provided with a full year of HRT prescriptions, lab work, medical letters related to transition, and virtual consultations.


Genderbands is an organization that aims to provide financial assistance for transition-related costs. They offer $1,000 transition grants that are application-based. The applications open every year from November 1st to December 31st, with seven different types of grants offered. As of August 2021, they have awarded $94,000 in grants. 


FOLX is an LGBTQ healthcare company that has collaborated with the Black Trans Advocacy Coalition (BTAC) to provide an HRT Care Fund. If awarded a grant, you will have 12 months of HRT coverage for prescription medication, consultations, and laboratory services. These grants are also application-based, and eligibility is limited to 33/50 states. Use this link to see if your state is eligible. 

The LOFT LGBTQ+ Community Center 

The LOFT is an educational and advocacy organization dedicated to furthering LGBTQ+ rights. Their program TransMission gives out scholarships to transgender and non-binary applicants for transition-related finances. These grants are also application-based, and applications will open September-October 2022. 

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The Happy Transgender Center 

Led and funded by Dr. Rizi Xavier Timaine, this organization offers an annual scholarship for gender-affirming surgery needs. Like the other programs, this scholarship is also application-based. Gender-affirming surgery can be significantly more costly than HRT and, in some instances, can cost over $100,000 out-of-pocket. 

HRT Frequently Asked Questions (FAQs) 

The following questions can help you decide whether or not HRT is right for you. Deciding to pursue HRT can be a challenging decision, and it is important that you have supportive healthcare providers to help you along the way. 

Am I a good candidate for HRT for gender affirmation? 

The WPATH recommends that hormone therapy is only started after you have been properly assessed by a mental health professional. If your provider determines that you are eligible after your consultation, you will receive a referral to bring to your physician. The criteria that a mental health professional looks for include: 

  • Persistent gender dysphoria
  • The ability to consent and make a fully informed decision
  • 16+ (although there are exceptions)
  • Healthy or well-controlled comorbidities

How do I find an LGBTQ+-friendly doctor? 

Finding an LGBTQ+-friendly doctor is vital to ensure that you get the proper care needed for a successful transition. Several LGBTQ+ health organizations provide resources to help you find non-discriminatory healthcare providers. Find out more about how to find an LGBTQ+-friendly doctor in another one of our articles.  

What are the side effects of HRT? 

The side effects of this therapy are important to keep in mind so that your health and well-being are appropriately monitored throughout your treatment. The side effects of masculinizing and feminizing hormone therapy can be incredibly different. The following list outlines the possible side effects you might experience when on either of these treatments. 

Masculinizing HRT side effects:  

  • Weight gain
  • Acne
  • Male-pattern baldness
  • High blood pressure
  • Type 2 diabetes
  • Pelvic pain
  • Infertility

Feminizing HRT side effects: 

  • Blood clots
  • Dyslipidemia (irregular amount of fats in your body)
  • Infertility
  • Weight gain
  • High blood pressure
  • Type 2 diabetes
  • Increased risk of breast cancer

Bottom Line

Hormone replacement therapy helps change hormone levels to better match your gender identity. Cost can be a significant barrier in accessing HRT, especially if you are uninsured. Before deciding to pursue HRT, it is fundamental that you evaluate your financial situation and check your eligibility for Medicare or other financial assistance programs. 

Additionally, obtaining LGBTQ+ friendly healthcare can be a challenging process. Mira offers affordable health coverage with providers who can be the first step in your transition journey. For just $45 a month, Mira offers affordable primary care consultations, discounted prescriptions, and laboratory services. Learn more about Mira today!

Sophie Wei

Sophie is a 2024 Pharm D. candidate studying pharmacy at Rutgers University, New Brunswick. She has a passion for healthcare and writing and hopes to make meaningful contributions to healthcare transparency and accessibility. In her free time, she likes to take care of her houseplants, cook, and hang out with her cat.