At 19 years old, Lexi Richardson came out as transgender to her father. A Navy SEAL with a penchant for being "very strict," she said, he reacted with a swift, all-too-familiar response: Richardson had to go.
"He provided me with an ultimatum," she said. "I could live at home or I could dress like a woman. So I said, BYE!"
Without a permanent home or the financial support of her parents, the salt in the wound, Richardson said, was the crushing reality that she may never be able to afford the gender-confirming surgery she longs for. In a last-ditch effort to change that, Richardson launched a GoFundMe campaign in 2012. "I need the surgery like I need air to breath," she wrote in the description. Slowly, donations from more than 100 strangers began to trickle in.
"I represent myself as strong-willed, outspoken and proud, but inside I'm a scared little girl," Richardson told me. "I really needed the help."
She's not alone. For transgender people, who face employment discrimination, anti-trans health insurance policies and a bevy of other financial hurdles, "coming out" can come with a price tag. In May 2014, a federal review board lifted a decades-long ban on Medicare coverage for gender reassignment surgery, though the procedures -- which range from $4,000 to $50,000 or more -- are still excluded from most private insurance plans. As a result, transgender Americans who can't afford the procedures and don't qualify for Medicare (the program only applies to those over the age of 65) are forced to take matters into their own hands.
In recent years, crowd funding has provided a much-needed financial boost. In April 2013, a group of fraternity brothers at Emerson College raised more than $20,000 on IndieGoGo for the top surgery of a young pledge. In October 2014, transgender performance artist Shakina Nayack's YouCaring campaign topped $22,000.
The approach also works for more modest efforts. Kyle Cabral, a 25-year-old, Massachusetts-based trans man, turned to crowd funding after his insurance company denied coverage of his lower surgery. He launched an IndieGoGo campaign in April 2013 and, within two months, raised the entire $6,500 expense.
"I am not the type of person to ask for help, it's not my MO normally, but I was getting to the point where I felt like I couldn't go on any longer without surgery," Cabral said. "I knew this is what I needed to be comfortable with myself."
Zeller Ash, a trans man living in Colorado, shared a similar experience. Ash has been "binding," or purposefully flattening his chest to combat gender dysphoria, for a decade, he said. With the help of GoFundMe, Ash's "boob evacuation and relocation fund" has raised close to $1,500, and he hopes to nab another $7,000 by his 30th birthday in May.
"A lot of trans guys are in the same predicament," he said. "We know [surgery] is expensive, we know most insurance companies don't cover it, but we're doing what we can."
Not every crowd funding campaign is profitable. For trans men and women without access to a computer, social media finesse or, perhaps most importantly, an emotionally-compelling narrative, it's not even an option. Likewise, for a population marked by suicide and depression -- about 41 percent of transgender individuals, and 69 percent of homeless transgender individuals have attempted suicide, according to recent statistics -- financial uncertainty and medical urgency are a dreaded one-two punch.
Dru Levasseur, co-founder of the Jim Collins Foundation, a non-profit transgender financial assistance organization, said this is where the practice falls short.
"There's no question of the need out there," Levasseur said. "Crowd funding is good, it's a sign of empowerment, but it's limited to a certain type of person. It's wonderful that people have been successful, but you shouldn't have to be charismatic to get health care."
Lexi Richardson doesn't want to wait any longer. After a financial snafu forced her to use campaign funds for basic necessities -- Richardson said she lost government benefits after her bank account showed the fruits of her fundraising labor -- she launched a new page on July 23. Richardson doesn't expect this attempt to be any easier, but this time around, she's won an unexpected ally.
"My mom sent a box of stuff for my birthday, and inside was a new purse that my dad picked out for me," Richardson said. "I'm not one of those girls that's like, 'look at my bag,' but it was really sweet. It meant a lot to me."
Perhaps her fundraiser will also come around.