How I Paid for Top Surgery Without Waiting, Interest, or Having to Tap My Emergency Fund (and How You Can Too)
My wedding was already scheduled for October, and even though I had known that I wanted top surgery since early on in my transition, it wasn’t until March 2024 that I was finally ready. The problem is that most surgeons covered by my insurance were scheduling out an entire year just for a consultation. To wait for that, I would either have to sacrifice my dream of being in my “right” body for my wedding, or put off the big date even longer. On top of that, I didn’t even know if I’d have the same insurance by the same time next year, or if that surgeon would still be covered!
I knew there had to be a way to make it all work out, I just hadn’t figured it out yet. When I did figure it out, not only was I able to get top surgery with my dream surgeon, Dr. Daniel Medalie, but I was able to pick a surgery date one month out.
Not because I had $10,000 sitting in a bank account. Not because my insurance covered it. And not because I had a family who was going to help me out.
I scheduled it because I had a plan — and I want to share that plan with you, because I genuinely believe it can change what feels possible for you.
Maybe your situation sounds like mine. Maybe you’re one of many who is afraid of gender affirming care being banned in your state before your date. Whatever your reason for fast tracking top surgery, I want you to know that you are valid, and I don’t want you to go into crippling debt to pull it off.
This is not a story about being lucky or having the "right" financial situation. It's a story about building a strategy out of nothing, using tools that are available to anyone, and choosing to treat gender-affirming care as exactly what it is: a financial goal worth planning for.
First, Let's Talk About the Real Numbers
Top surgery costs vary depending on your surgeon, location, and what's covered by insurance. Here's exactly what mine looked like with Dr. Medalie in Cleveland, Ohio:
Surgeon fee: $5,252
Credit card surcharge (surgeon's office): $157
Anesthesia: $850
Facility fee: $1,562
Airbnb for recovery: $917
Gas, food, and supplies: the rest
Total Goal: $10,000.
The hard costs alone came to just over $8,700. I rounded up to $10,000 deliberately — to cover supplies, gas, food during recovery, and anything unexpected. That buffer wasn't paranoia. It was planning. And I'm glad I had it.
The other number you need to know: I did not touch my emergency fund to pay for this. Not one dollar.
That was the whole point.
Why Keeping the Emergency Fund Intact Was Non-Negotiable
Here's something I see constantly in trans financial planning spaces: people treating their emergency fund like a piggy bank. They raid it for a big expense, tell themselves they'll rebuild it later, and then life happens and "later" never comes. I’m not trying to shame anyone who’s done this, I’ve done it too.
Your emergency fund is not a savings account. It is your safety net. For queer and trans people especially — who are statistically more likely to face sudden job loss, housing instability, and family financial withdrawal — draining that fund to pay for surgery means going into your recovery period with no cushion at all.
Quickly after my parents cut me off for coming out as trans, I realized that I had to be my own safety net from then on, so preserving my emergency fund was non-negotiable for me.
I needed a strategy that let me pay for surgery and leave my emergency savings completely alone.
Here's what I built.
The Strategy: Three Tools Working Together
1. A dedicated savings account, separate from everything else
The first thing I did was open a High Yield Savings Account (HYSA) specifically for top surgery. Not my regular savings. Not my checking account. A completely separate account, nicknamed something that made me feel something every time I looked at it: Top Surgery.”
A HYSA earns significantly more interest than a standard savings account — often 10 to 20 times more (this is why my emergency fund also lives in an HYSA). If you’re still earning only fractions of a percent in interest by leaving all your cash in a traditional savings or checking account, you’re literally leaving free money on the table.
While I was building toward my $10,000 goal in the months leading up to top surgery (through saving some of my pay + fundraising), my money was working for me in a small but real way. By using a HYSA for my top surgery savings, every dollar I set aside was also earning a little more on top of itself.
More importantly, keeping the money in a separate account from my checking and Emergency fund meant I wasn't tempted to dip into it, and I could see my progress clearly. My wife and I also drew a thermometer chart on construction paper and hung it up in our kitchen so we could update it and look at our progress every time we were waiting around for the microwave. Watching that number grow toward $10,000 made the goal feel real in a way that keeping it mixed with everything else never would have, and drawing that little fundraising chart made the bake sales and off hours handy man work feel instantaneously rewarding (yes I fundraised for my top surgery like a church mission trip - if they can ask for money to go play colonialism, then I can bake sourdough bread for the trans agenda).
I recommend opening a HYSA with SoFi, Ally Bank, Discover, or Marcus by Goldman Sachs — all offer competitive APYs. It doesn’t really matter which one you pick, as long as you choose one!
2. A 0% introductory APR credit card — USED STRATEGICALLY
This is the part of my story that surprises people the most, because we're taught that using a credit card to pay for medical expenses is a trap. And it DEFINITELY can be — if you don't have a plan.
I used the Amex Blue Cash Preferred Card, which at the time offered a $200 welcome bonus, a waived $95 annual fee for the first year, and a 0% introductory APR for 12 months on new purchases.*
Here's how I used it:
My partner and I each had $5,000 saved in our emergency fund HYSA which we had steadily grown over the last year
Instead of withdrawing that money to pay the surgeon directly, putting us at zero, we put the surgical fees on the Amex card at my appointment.
I left my HYSA untouched, earning interest.
Then I paid off the card balance in full — in under a year — using the money I'd already saved, and a portion of my paychecks, broken into monthly payments.
Because I paid it off before the 0% intro period ended, I paid zero interest. Zero. The surgery cost me exactly what the surgeon quoted, not a dollar more in financing fees.
Having our emergency funds already set up gave me a lot of peace of mind, and made this whole plan possible, so if you haven’t built yours yet, I’d highly recommend starting there before attempting to pay for surgery on a credit card.
I need to put in this disclaimer: even in our situation, where we had the money in the bank we needed to pay off the full surgery cost, accidents happen and using our emergency funds as emotional collateral to tolerate the risk of going 10K into credit card debt was not foolproof. At some points we were technically only one major hospital bill, car accident, or layoff without a new job away from carrying that balance into a predatory APR spiral of debt, but I guess in some way, we all are.
*not sponsored, just being transparent about exactly what I used
3. The welcome bonus and cashback offset the credit card surcharge
Here’s a small detail of my plan that made this strategy feel smarter amidst my fears of worst case scenarios: my surgeon's office charged a small percentage fee for paying by credit card rather than check. This is common, and it's the thing that makes people hesitate to use a card at a medical office, including myself.
But here's the math that changed the equation for me:
The Amex welcome bonus at the time: $200 cash back
The cashback I earned on the surgical charge itself: additional dollars back on the purchase
The credit card surcharge my surgeon charged: $157
The welcome bonus alone more than covered the surcharge. Add the cashback earned on top of that, and I actually came out ahead compared to paying by check — while also getting 12 months of 0% financing.
This is what I mean when I say strategic debt. Not reckless. Not avoidance. A calculated move that used the tools available to me to get what I needed while keeping my financial foundation intact.
And here's the part I didn't expect: I never canceled the card. Two years later, the Blue Cash Preferred is my primary everyday card. It earns 6% back on groceries, which more than covers the $95 annual fee that kicked in after year one. What started as a surgery financing tool became a permanent part of how I manage money — because I chose it intentionally rather than reactively.
What This Strategy Requires (Honesty Time)
I want to be real with you, because I am not here to sell you a fantasy.
This strategy works best if you:
Have time to save before surgery. I scheduled my procedure one month out, but I'd been saving for many months before that. The one-month window was when I had my savings fully built and was ready to move.
Have a credit score that qualifies for a 0% APR card. Most of these cards require good credit (generally 670+). If your credit isn't there yet, building it is worth prioritizing — and there are other strategies for financing surgery in the meantime.
Can commit to paying off the card before the intro period ends. The 0% APR is only magic if you clear the balance in time. If you don't, you get hit with the retroactive interest rate, which is not the move.
Have a plan, not just a hope. The reason this worked is that by the time I put the surgery on the card, the money to pay it off was already sitting in my HYSA. I wasn't gambling. I was executing a plan I'd already built.
If any of those pieces aren't in place yet, that's okay. It just means your first step is building the foundation — and that's exactly the kind of work I do with clients.
What I Want You to Take Away From This
Gender-affirming care is a financial goal. Full stop.
Not a luxury. Not something you have to suffer to access. Not something you should have to GoFundMe your way into (though, there is no problem with utilizing tools like GoFundMe to help). Gender Affirming Care is a goal — like a down payment on a house, or paying off debt, or building an emergency fund — that deserves a real financial plan built around it.
You are allowed to be strategic. You are allowed to use the tools available to you — credit cards, HYSAs, cashback rewards, introductory offers — the same way wealthy people have been using them for decades.
Nobody gave you the roadmap. But that doesn't mean there isn't one.
Want Help Building Your Own Plan?
If you're reading this and thinking okay but how do I actually do this for my specific situation — that's exactly what I help with.
The Queer Money Map is my 7-month 1:1 financial coaching program, built specifically for queer and trans people who are starting from scratch or feel like financial security is for someone else. One of the core modules — Waypoint 4: Your ONE BIG GOAL — is exactly this: building a step-by-step financial roadmap for the biggest, closest thing on your list, whether that's surgery, moving to a safer city, or something else entirely.
You don't have to figure this out alone.
Learn more about the Queer Money Map →
Elliot Bruhl (he/they) is a certified professional coach and the founder of Queer Money Movement. He helps LGBTQ+ beginners build financial security on their own terms — without shame, without jargon, and without pretending the system was built for us. Learn more at queermoneymovement.com.
Disclosure: This post may contain affiliate links in the future. If you open an account through one of my links, I may earn a small commission to help support my free content at no additional cost to you. I only recommend products I actually believe in and have researched thoroughly. Credit card terms change — always verify current offers directly with the issuer before applying.
