By Nicky Cao
TransLash Media published this article on our website with the author’s permission, and in TransLash Zine Vol. 4: Migration Stories.
My name is Nicky Cao and I am a 23-years-young Vietnamese-American, transgender womyn, born and raised in New Orleans. I came out as transgender when I was 16, but started my hormone replacement therapy at 18.
From the very beginning of my transition, I always felt insecure and unhappy with my self-image. Parts of it came from body dysmorphia,but most of it came from gender dysphoria. I remembered always comparing myself to the other trans girls I knew, or always comparing myself to women I saw on my social media feed. At 18, I already knew what surgeries I wanted to feel secure, happy, and beautiful as a transgender woman.
Living in the South, I had to accept that my state insurance and medicaid will not pay for my gender affirming surgeries. Furthermore, I realized that due to the little visibility of transgender people in the South, my plastic surgeon would not be here in the South. It took me accepting both of these truths to realize I can either work hard or I can work smart.
I tried working over 40 hours a week, working two jobs while doing school full time, but no matter how much I saved it seemed impossible to hit $5K — let alone $50K — for the intense surgeries I wanted. I applied for grants like Point of Pride, random ones my friends all sent me, and I was never selected. This was when I decided I would get my first breast augmentation at the age of 20 with my student loan money, but was given advice from a friend to save my money and either move to California or New York, where their insurance plans include and embrace transgender residents.
I decided that after I graduated from college I would move to either city, but then the coronavirus pandemic started. But just as I was going to give up my hopes and dreams of getting surgery, someone I met through the Instagram’s hashtag #girlslikeus, told me about how both Apple and Starbucks insurance pay for their transgenders employees surgeries. It was then that I decided to apply for both jobs. I got shot down by Apple, but Starbucks welcomed me with open arms.
Working at Starbucks for $10/hr was really rough in the beginning. I honestly could not afford to pay my rent, car insurance, and other living expenses. I ended up spending the money I saved for surgery on bills. About six months into the job, I was mailed information about qualifying for insurance. It was from this moment that I learned that Starbucks really pays for their transgender employees gender-affirming surgeries. I remember calling the Partner Resource Center asking for help choosing insurance, and they gave me my own transgender advocate who took the time to explain how Starbucks itself paid for the surgery, not the insurance. I remember just crying tears of joy, just hearing the confirmation from my advocate.
Once I enrolled for insurance, my advocate told me about the surgeries Starbucks covered, and even told me the doctor choices I had available. ALL of the doctor choices were top choice, well known, celebrity doctors who has had years of experience on transgender patients.
Fast forward to a year and three weeks after working at Starbucks: I finally did it. I got my facial feminization surgery and breast augmentation surgery in Beverly Hills — by the same doctor who did Caitlyn Jenner’s face.
Although insurance paid for surgery, I was still stuck with paying for flight and lodging of surgery. I paid over $5K alone just on flights and hotels! This didn’t even include me having to Uber back and forth between places, food, or paying for a caretaker.
My advice for transgender people traveling out of their state is to network with queer and trans people in the area to see if they can help set you up with affordable housing. Ask a friend or family member to take care of you, and you’ll probably even save money renting a car with them instead of ubering around.
My biggest advice to transgender people wanting surgery is to give hormones a few years before you go through with surgery. The surgeries I thought I “needed” and “wanted” when I first started my transition are not the same surgeries I ended getting, because hormones to some degree did help. Being on hormones for a few years gave me an idea on what exact things gave me dysphoria.
Be sure to do research on the surgeries you want done, and the method you want used to achieve surgery results as well. If it wasn’t for the transgender community I networked with through Instagram, I would have never learned about the difference between silicone or saline boobs, and the different ways they can be put in.
Another major thing to think about before getting surgery with a doctor, is making sure the doctor has experience with trans folks who share your race or similar features! I’ve seen doctors who performed surgery on some people where the results didn’t look as stunning, because they were used to doing one specific race.
If you end up wanting to do a different route, I would also encourage you to look into getting plastic surgery out of the country! I’ve seen so many beautiful transformations of transgender girls who got surgery done in countries like Korea or Thailand, and the surgery prices were more affordable and better in terms of results!
Nicky Cao is a second generation, queer, transgender, Vietnamese-American born and raised in a little village known as Versai, in New Orleans East, Louisiana. Her parents are both refugees of the Viêt Nam war which has greatly impacted her experience of living in the United States. Being the 14th child out of 15, Nicky was the first out queer/trans sibling in her family to have came out. In the beginning of her coming out story, Nicky thought she was simply a cis-gay man, but after her first Gay-Straight alliance meeting at her high school, she learned about the difference between gender and sexuality. It was then that she self-identified herself as gender-fluid at 16. It wasn’t until she moved out at 16, did she truly learn how to express herself through clothing and gender. Thanks to her freedom from family at 16, she realized she really identified as a transgender-woMYN. She officially went mainly by she/her pronouns when she embarked on her medical and physical transition her freshmen year of college at the University of New Orleans. Nicky graduated from the University of New Orleans with a bachelors degree in sociology in 2020. Nicky’s hobby include watching Disney movies, cuddling, playing League of Legends and exchanging wisdom/knowledge with community.
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