5 Things You Need to Know About Preparing for Gender Affirmation Surgery

Gender affirmation surgery (also called transgender surgery) refers to procedures that help people transition to their self-identified gender. As I’ve highlighted in past blogs, gender affirmation surgery continues to increase in popularity, with roughly 1 in 4 transgender and nonbinary persons choosing to undergo transgender procedures. But, gender affirmation surgery is a big decision that shouldn’t be taken lightly—which is why I’d like to share 5 things you should know about preparing for these procedures.

1. You’re not alone: talk with others

Based on the conversations I’ve been fortunate to have with my transgender and gender-nonconforming patients, I know how beneficial it can be to talk to others who have undergone gender affirmation surgeries. Talking to someone who has been in your shoes is often an invaluable experience, and can help you better understand what to expect during all stages of surgery.

Having a support system in place will be critical to your surgery, recovery, and overall well-being.

If you don’t know anyone who has had gender affirmation surgery, many cities have support groups and community organizations centered around this topic. You may also find it helpful to read first-hand accounts of others who have contemplated or undergone gender-affirming surgeries. Here are a few resources:

• Transgender Lives: Your Stories is an interactive campaign created by The New York Times that allows transgender people to tell their stories in their own words.
• I AM: Trans People Speak is a campaign created to raise awareness about the diversity of transgender communities by highlighting the voices of transgender individuals, as well as their families, friends, and allies.

2. It’s never too early to prepare for your recovery

Even if your surgery is months away, it’s not too early to start preparing. I recommend writing down any and all questions you may have about your recovery and discussing them with your medical provider. Be sure to find out the following:

• What you can do to proactively support an ideal procedure, such as getting proper nutrition
• How long of a recovery period your gender-affirming procedure(s) will require
• What medications and supplements you will need to discontinue
• What medications and post-operative devices you will need to aid your recovery

You can also use this time to make plans for adequate time off work for surgery and recovery, as well as make arrangements with a friend, SO, or family member to help care for you during the initial recovery period.

Additionally, make sure you will have the right professional support system in place during and after your procedure(s): it will be critical to your surgery, recovery, and overall well-being. This support system will likely include: 1) working with a therapist or other mental health provider, 2) working with a board certified cosmetic surgeon, 3) working with a urologist or gynecologist (if you’re having genital surgery), 4) scheduling routine visits with a primary care doctor who specializes in transgender patients.

3. Weigh the risks and benefits of surgery

Patient education is one of my top priorities at my Bellevue cosmetic surgery practice, which is why I always make sure my patients are fully aware of what to expect from surgery, including risks. Even if you’re 100% committed to having gender affirmation surgery, it is important (as it is for any surgical patient) to be sure you are comfortable with the known risks of the procedures you wish to have.

Risks of gender affirmation surgery

Like any major surgery, possible physical risks associated with gender affirmation surgery include allergic reaction, infection, bleeding, and bruising. Gender affirmation surgery can carry a few additional unique risks, such as the inability to reproduce (though there are ways to preserve your fertility prior to surgery) and nipple necrosis (death of the nipple due to repositioning and/or resizing). Most physical risks can be mitigated by choosing very experienced providers and following all pre- and post-operative instructions.

Possible non-physical risks of gender affirmation surgery are regretting your decision to change genders and struggling with psychosocial changes (e.g. challenges with family and loved ones, adjusting to your new identity, etc). These risks can often be mitigated by taking time with your decision and working with a therapist or other mental health provider.

Benefits of gender affirmation surgery

From the physical to the mental, the benefits of gender-affirming surgeries are vast. Here are a few patients have reported experiencing:

• Trans and gender non-conforming patients often report feeling more “at home” in their bodies, leading to an increased feeling of well-being and improved quality of life.
• A new study in JAMA Surgery found that gender-affirming surgery was associated with a 42% reduction in psychological distress, a 44% reduction in suicidal ideation, and a 35% reduction in tobacco smoking.
• According to an American Journal of Psychiatry study, one’s odds of needing mental health treatment declined by 8% each year after their gender-affirming surgery.

Trans and gender non-conforming patients often report feeling more “at home” in their bodies, leading to an increased feeling of well-being.

4. Alternatives and complementary options

Surgery isn’t always part of a person’s transition; there are many who identify with a gender other than the one they were assigned at birth who make non-surgical physical changes instead. These may include:

• Hormone therapy to increase masculine or feminine characteristics, such as body hair or vocal tone.
• Puberty blockers to prevent the onset of puberty.
• Voice therapy to adjust your voice/tone.

If you want to make additional physical changes, non-surgical procedures like laser hair removal, BOTOX®, and dermal fillers can go a long way in helping add masculine or feminine characteristics to your appearance.

Social changes to help decide if surgery is right for you: Before you seriously consider undergoing gender affirmation surgery—or make any physical changes to your body—you may want to practice physically presenting as your desired gender (or non-gender) in public, asking to be called by your preferred pronouns, unofficially adopting a new name, and/or coming out to those around you. Taking these steps can help you determine whether you want to undergo surgery or make any of the above changes instead.

5. Transitioning doesn’t end with surgery

It’s important to understand that, for most people, surgery is only one part of the transitioning process. After surgery, it’s very important that you continue to work with a therapist or counselor who specializes in transgender patients.

You may also consider legally changing your name and identification. You can find out how to change your name in King County here, and how to update the gender listed on your driver’s license here. In most states, it can be incredibly difficult to change the name and gender listed on your birth certificate, but the State of Washington doesn’t require any proof of clinical treatment; learn more about the process here.

Gender-affirming cosmetic surgery in Seattle

As a trans-friendly board certified cosmetic surgeon, I have been performing gender affirmation procedures for many years, including breast implants, Adam’s apple reduction, laser hair removal, facial feminization, and breast removal/mastectomy. If you are considering gender affirmation surgery in the Seattle area, I would be happy to discuss the best procedures to fit your goals and what you can expect from surgery. Contact my office online or call (425) 453-9060 to schedule a private consultation with me.