Gastroesophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD. Both acid reflux and heartburn are common digestive conditions that many people experience from time to time. When these signs and symptoms occur at least twice each week or interfere with your daily life, or when your doctor can see damage to your esophagus, you may be diagnosed with GERD.
In Pennsylvania, the Philadelphia Center for Transgender Surgery posts cost estimates for different procedures. Its price list mentions estimates of $140,450 to transition from male to female, and $124,400 to transition from female to male.
1 These coaches can cost $30 an hour or more. 2  After surgery, it sometimes is necessary to consult a lawyer or pay fees in order to change the sex on official documents such as the birth certificate, driver's license and passport. The LGBHealthChannel.com has an overview of transgender hormone therapy. 2  Usually, an experienced mental health professional must diagnose gender identity disorder in order for hormones to be prescribed. 3  If psychotherapy is required, it can cost $50 to $200 per session for patients not covered by insurance.