Ryan Levy, MD, chief of thoracic surgery at UPMC Passavant

It’s a big step in your transition to decide to undergo gender-affirming surgery. Most likely, you spent a while thinking over your options — and maybe talking with others to make your decision. Now, it’s time to prepare for the procedures themselves.

You may have a lot of questions about the process. These can include what to expect from appointments and how to prepare for your hospital stay and recovery. These can also include how to ensure you’re mentally ready for this big step.

Learn About the Standards of Care

Consider downloading a copy of the World Professional Association for Transgender Health (WPATH) Standards of Care. This long PDF booklet is well-organized and easy to search, and it includes answers to many of the questions you probably have.

The WPATH Standards of Care also let you know what your procedures should entail based on the most current evidence. If your providers recommend a plan that differs from these guidelines, it might be helpful to ask them why. Each person’s needs are different, so your providers might have a good reason for offering something different.

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Consider Your Fertility Options

It’s important to think about your family planning goals and consider whether they could change in the future. Some people want to be able to conceive after gender-affirming surgery. Others may simply want to preserve eggs or sperm so they have more options later.

Talk to your doctor about your options for preserving your fertility. Then, decide whether you want to preserve your fertility or explore other family planning options before surgery.

Prepare Yourself Mentally

You may have been thinking of gender-affirming surgery for years, but it’s a big step. It’s important to give yourself time to mentally adapt to the changes your body will undergo. It’s also helpful to hear about others’ experiences so you know what to expect.

Read stories about others’ gender-affirming surgery experiences. Reach out to support groups and look for people you can talk to about their experiences. What they felt will not necessarily be the same for you, but it might give you some ideas of what to expect.

Talk to your surgeon about whether they have any pictures of previous results. Ask them if there are any previous patients you can talk to.

Here are some questions to consider asking someone about their gender-affirming surgery:

  • What aspects of your surgery did you not expect?
  • Did you have pain or discomfort after your surgery? If so, how bad was it?
  • How long did your recovery take?
  • How do you feel about your decision now?
  • What do you wish you had known before your surgery?
  • What advice do you have for someone about to have surgery?
  • Is there any aspect of the process you wish had been different?
  • Do you hope or plan to have more procedures?

Plan for Your Recovery

It will take time for your body to heal after each procedure you have. Ask your doctor how long recovery will likely take and what it might involve. Plan ahead for what you might need during your recovery period.

On the day of your surgery, you may need to have someone with you to help with your discharge and to remain with you for the following 24 hours.

During your recovery, reach out to supportive friends and family who can help you. You may need help with meal prep, rides, or even intimate activities such as using the bathroom. The more support you have, the more smoothly your recovery process will likely go.

If you don’t have friends or family who can help, reach out to local support groups to see if they have anyone who can help. Ask your doctor for a post-surgery recovery plan ahead of time so you know what to expect.

Gender affirming surgeries can have a huge impact on a person’s life, and it is vital to have an emotional support system in place during recovery. Keep in mind that recovery and healing may be more challenging for some surgeries, and you may benefit from mental health or therapist support.

Ensure You Have All Your Paperwork

Gather any papers you might need for your pre-op appointment. That’s the meeting before your surgery. This paperwork might include:

  • A list of all prescription and over-the-counter medications you’re taking.
  • Pharmacy and medical records about your hormone therapy.
  • Medical records from your primary care doctor.
  • Letters stating that you’re ready for surgery if the center requires them.
  • Insurance information.

Your pre-op appointment is also a chance to ask your surgeon any questions you have. Think about what you might want to ask, and write your questions down so you remember to ask them.

During your pre-op appointment, you can find out exactly what your surgery will involve and what risks you might face. Ask what the plans are if anything unexpected occurs and what to expect after surgery. Bring a notebook and writing instrument to write down your doctor’s answers.

Standards of Care for the Health of Transsexual, Transgender, and GenderNonconforming People. The World Professional Association for Transgender Health. Link

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