Only expensive one is puberty blockers. Hormones are really cheap.

even the blockers are not that expensive, and they're only being used for a couple years, I think?

Usually only a couple of years but they are 100s to around 2,000 a month which is expensive but not crazy. Hormones are around 10-50 a month.

yeah that's cheaper than GLP-1s

Which are often not covered for exactly that reason

Even though it's dropped a lot since the early '00s (due to health concerns which AFAIK should now be alleviated), something like 5% of menopausal cis women use HRT, and a lot of cis men use testosterone. The trans market probably isn't *nothing* to them but it's definitely not a majority

Big Pharma could make orders of magnitude more money by re-convincing menopausal women that HRT is safe enough to be worth it (since current estradiol formulations are safer than the old conjugated estrogens) than they ever will by selling hormones to trans people