Gender-Affirming Surgery: How to prepare for it

Preparation for gender-affirming surgery begins long before entering the operating room. In fact, it can start even before the first visit with the surgeon. The first step is to thoroughly research the available procedures and choose a medical team with experience in gender-affirming surgery that gives you confidence and security.

Once you have selected two or more surgeons you wish to meet, it’s time to schedule an appointment with them and decide who you want to perform your surgery with.

These are the main aspects to consider before gender-affirming surgery:

Seek detailed information about the different procedures and alternatives available and look for guidance from professionals specialized in transgender health.

Find a specialized surgeon with documented experience in the procedures you are considering. Gender-affirming surgery includes different operations such as trans vaginoplasty, trans phalloplasty, mastectomy or facial feminization surgery. As well as different techniques for each surgery.

Having a team of experienced specialists who can adapt to each person’s needs is the best guarantee.

Schedule a medical appointment to meet the surgeon you wish to operate with and discuss your options. Ask all the necessary questions about the surgery you are considering and evaluate your connection with them. It is crucial that you are honest with your doctor and feel safe in their care.

Review your expectations

Understanding the limitations of each procedure and the expected results is fundamental to aligning your expectations with reality.

Ask your surgeon for images of previous gender-affirming surgeries and, if possible, testimonials from other patients who have undergone the same procedure. This can help you get a better understanding of what to expect.

Before any intervention, a series of documents and reports are required to ensure that your health status is suitable for surgery and to facilitate medical planning.

Here are some of the necessary steps before genital surgery or other gender-affirming procedures:

• Complete medical history: Including details about hormone treatments, previous surgeries, and health conditions.
• Identification document: To prove your legal age and identity at the time of gender-affirming surgery. In specific cases, Spain’s Law 4/2023 allows surgery in minors under certain legal and medical conditions.
• Informed consent: The responsible surgeon will provide a document explaining the surgery or surgeries involved, the expected outcomes, possible complications and risks, benefits, any alternative treatments, and other relevant information. It is important to read this document carefully before signing and ask for clarification if needed. Surgery cannot proceed without it.
• Medical evaluation: Although the Trans Law promotes the depathologization of trans identities, medical evaluations are usually conducted to ensure the patient’s suitability for surgery based on general and specific health criteria.
• Legal certificates: Depending on your situation, you might need documentation proving your name or gender change, especially when accessing public healthcare. The 2023 Trans Law in Spain simplifies these procedures, removing some administrative barriers.
• Laboratory tests and other diagnostic exams: Blood tests and other pre-surgical assessments will be requested by the medical team according to the patient’s clinical history and the type of gender surgery to be performed.

Although in Spain access to gender-affirming surgery generally does not require a positive report from a specialized mental health professional, some medical institutions offer psychological support as part of the preoperative process to ensure the patient’s overall well-being.

Emotional health plays an important role throughout the transition. Working with a specialized therapist can provide emotional support before and after the procedure, helping to explore personal motivations and cope with any challenges that may arise.