Before the Procedure

A consultation with a surgeon is the first step in bottom surgery. This meeting helps us get to know you and develop a personalized care plan.

We review your surgery options, the risks, and what to expect. The consultation may also include a physical exam, if needed.

To proceed with surgery, you must meet our surgical criteria and the WPATH guidelines for your chosen procedure. In general, the requirements include:

• Age 18 or older
  
• Diagnosis of gender dysphoria
• Good control of mental and physical health conditions
• Hair removal
• Abstinence from any inhaled or vaped substance including tobacco and cannabis
• Support from family or friends to drive you home from the hospital and to early follow-up appointments
• Two letters of referral from a qualified mental health professional (often required by health insurance companies)

Meeting these requirements often takes time and help from other health professionals. Our care coordinator can connect you with services you need before your surgery.

After the Procedure

Depending on the type of procedure, you may go home the day of surgery or stay in the hospital for up to 10 days.

At the consultation, we develop a plan for your postsurgical care that may include providers closer to home. We track you closely through frequent follow-up visits or work with your local provider to monitor your progress. Pelvic floor physical therapy is a frequent part of care after bottom surgery and can speed healing and prevent future complications.

For people undergoing genital affirming surgery, we recommend making an appointment with your mental health care provider about four weeks before surgery.

In the longer term, it’s important to see your primary care provider for routine checkups. If you don’t have a primary care provider, Stanford Health Care’s LGBTQ+ Health Program provides comprehensive primary care and other specialty services in a supportive, inclusive environment.