Your path to a new life!
Bergisch Gladbach (near Cologne)
& Hamburg – gender-affirming surgery in a respectful and safe environment
At the Praxisklinik am Rosengarten, we support trans*, non-binary and gender-diverse people as well as all individuals with chest dysphoria or the desire for a more harmonious chest shape – medically sound, personally attentive and without unnecessary obstacles. Our goal is treatment that suits you: individually planned, safely carried out and closely followed up – in Bergisch Gladbach near Cologne and Hamburg.
What we offer you
Specialized gender-affirming chest surgery
Surgical technique & aftercare
Respectful, affirming communication
A protected environment
Optional: Support with networking
Costs & cost estimate – transparent and plannable
The costs depend on the scope and the chosen surgical method. You will receive from us a detailed cost estimate, which usually includes:
- medical fees
- clinic/surgery costs
- inpatient care (if planned)
- medical material costs
- meals and accommodation during the stay
Possible additional costs
Depending on your individual situation, additional expenses may arise, e.g.:
- Anesthesia (if billed separately)
- Compression garments (usually recommended for several weeks)
- Follow-up cost insurance (optional, depending on your wishes/coverage)
- Scar care products
- Travel and accommodation costs (journey, hotel, accompaniment
Important: We advise you openly about which items are realistically incurred in your case – so that you can plan with confidence.
Payment & financing
The surgery costs are due before the procedure. We generally cannot offer installment payments directly through the clinic.
If you would like financing, we are happy to give you information about external financing partners who specialize in medical/aesthetic procedures.
Health insurance: cost coverage (GKV/PKV) – what is possible?
Statutory health insurance (GKV)
In Germany, whether cost coverage is possible often depends in practice on an individual application and the case-by-case decision of your health insurance provider. We are happy to support you in structuring the documents sensibly and understanding the next steps.
Private health insurance (PKV) & self-payers
For privately insured patients and self-payers, treatment is generally possible at any time – after medical examination and individual planning in the consultation.
Patients from abroad
For international insurance, we cannot give a blanket commitment regarding cost coverage. Please clarify the reimbursement options directly with your insurance in your home country.
Your next steps – simple, clear, without pressure
1) Arrange a non-binding consultation (video or on-site)
We talk about your concern, your goals and the suitable surgical option. You get clear information about the procedure, risks, healing and costs – in an atmosphere where you can feel comfortable.
2) Receive documents & review them at your leisure
After the consultation, we send you all relevant documents by email. Take your time, read everything carefully and note down questions.
3) Request a surgery appointment when you are ready
You decide the pace. As soon as you are ready, we plan your surgery appointment together.
4) Second on-site consultation for final surgery planning
We clarify details, measurements/planning, medical questions, the course of the surgery day and aftercare – so that you feel safe.
5) Ask questions – as often as you like
We want you to make a well-informed decision. Ask all your questions until everything is really clear.
Frequently asked questions about Go your own way!
We are happy to answer your questions here about the current legal situation, cost coverage and applications.
As a rule, yes. Each gender-affirming measure must be applied for and justified individually. However, your therapist can often build on the existing progress report and supplement it with the specific indication for the new procedure (e.g. correction of the body contour or breast reconstruction).
Yes. You will receive a detailed surgical information letter (doctor's letter) from us, which explains exactly why the surgery is medically necessary. We know which wordings the MDK pays attention to.
According to the current BGA guidelines (assessment guidelines), hormone therapy is not a mandatory prerequisite for a mastectomy, provided that the medical necessity can be justified in another way. However, many MD assessors like to see hormonal pretreatment as part of the "everyday life test". We will advise you in a personal consultation on how best to document your individual path.
That depends on your insurance status. Private health insurance providers often cover the costs without any problems, depending on the tariff. For those with statutory insurance, coverage of costs in a purely private clinic is usually only possible through the cost reimbursement system (according to § 13 para. 3 SGB V), if no comparable treatment is available in a contracted clinic in a timely manner. We are happy to inform you about the options at our clinic.
The "Big 5":
- Indication letter & progress report (therapist)
- Gynecological/Urological exclusion findings (intersexuality ruled out)
- Endocrinological findings (hormones, if applicable)
- Trans curriculum vitae (personally written)
- Our surgical certificate
That depends on the effort and the method. After the consultation, we will create a binding complete offer for you, so that you have planning security.
A rejection is, first of all, no reason to despair. You have the right to file a written objection within one month. Often, the insurance funds merely request further details or specific wording in the reports. In this case, we are happy to support you with a medical statement to once again substantiate the necessity of the procedure.
In Germany, statutory health insurance funds (GKV) generally cover the costs of gender-affirming surgeries that are deemed medically necessary in cases of diagnosed gender dysphoria. These usually include mastectomy, breast augmentation (under certain conditions), as well as gender-affirming genital surgeries. Treatments such as facial feminization surgery (FFS) or permanent hair removal are often decided on a case-by-case basis.
For a complete application to the Medical Service (MD), you usually need:
- A specialist psychiatric or psychotherapeutic indication (confirmation of the diagnosis and necessity of the surgery).
- A detailed psychiatric/psychotherapeutic progress report.
- The surgeon's findings report (which you will receive after your consultation with us).
- A findings report from your endocrinologist (hormone status).
- A trans-identity CV (this is still requested by some insurance companies, but is legally disputed).
Once your application has been received by the health insurance company, it usually has three weeks to make a decision. If the Medical Service (MD) is called in for an assessment, the deadline is extended to five weeks. We recommend always sending the application by registered mail so that you have proof of when it was received.
Schedule appointment
Get a non-binding consultation now. We clarify all open questions and talk about the change you want.
Completely without pressure, completely non-binding and above all on equal footing and without prejudice!