Gender Affirming Surgery Grant Application

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DR DHT gives out this grant. It is open to transgender, nonbinary and other trans identifying people who are in need of funding for gender affirming surgery such as; top surgery, bottom surgery and more.

What is your full name? *

What is your Instagram handle? *

What's a good contact email to get ahold of you? *

What is your identity? (trans man, trans masc, trans woman, non binary etc.) *

What are your pronouns? *

What surgery are you needing funding for right now? *

Top surgery

Bottom surgery

Other:

Do you have a surgery date set already? *

Would you consider yourself low income? *

Yes

Maybe/unsure

How would you describe your need for donations when it comes to acquiring this gender affirming surgery? *

very high need, completely relying on donations, no savings or health coverage

high need, largely relying on donations but not fully

partial need, relying on some donations, but have/will have some personal funds/health coverage

somewhat relying on donations, have personal funding/or some health insurance coverage, but donations would help

Not relying on donations but they would help

Other:

Paste the link to your Gofundme or other donation platform. *

How did you find out about this grant? *

From the creator/creator's social media page

From someone sharing it on social media

Other:

Agreements

I (person applying) understand the applying does not secure me the grant. Numerous people will apply and there will be a recipient(s) who will be notified if they are chosen. *

I understand.

If I (person applying) receive the grant, I ensure it will be used for my own gender affirming surgery costs. *

This is correct.

If you are chosen as the grant recipient, are you comfortable with being reposted and tagged on social media as the winner? *

Yes

Other:

Is there any information you'd like to include, or be considered in the application process?

Submit

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