( on the Internet with a family physicia...)Making Change: The Cost of Being Transgender,Health

on the Internet, with a family physician, or through a community organization. But many low-income parents can't afford access to those resources.

Children from poorer families are more likely to be thrown out of their homes and end up on the streets.

Though the transgender community in the United States is small, roughly estimated at between 1 and 3 million people, it represents a broad diversity of people.

"Transgender can be anything from feeling internal body dysmorphia [an altered body image] to acting on it, as with cross-dressing, to actually changing your body through hormones, silicone injections and surgery," said Cris Beam, a journalist who spent seven years following a group of transgender youths on the streets of Los Angeles for her book "Transparent."

Those who want surgery and can afford it can spend $10,000 to $20,000 for a sex-change operation.

But for most transgender people, surgery is not an option. Their primary concern is simply making ends meet.

"The vast majority of [transgender] people are poor," said Chris Daley, director of the Transgender Law Center. "Being trans affects their economic health and means unemployment and underemployment. There is a real material cost in transitioning."

In San Francisco -- arguably the most transgender friendly city in the country and home to the minority's largest population -- 60 percent of transgender people make less than $15,300.

Experts and advocates say that people obviously in the middle of transition are often discriminated against when looking for work. Those with jobs often cannot get their health insurance to cover the cost of hormone therapy.

"They're often turned away from places like McDonald's if they're visibly trans -- the most basic workplaces and most basic jobs," said Ray Carannante, associate director of the Gender Identity Project at the Lesbian, Gay, Bisexual and Transgender Community Ce
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