11 Tips on How to Choose a Gender Affirming Surgeon!

September 15, 2019 Dr. Natalia P Zhikhareva

More trans people than ever are now searching for gender affirming surgeons.

This is in thanks partly to the Affordable Care Act, which has dramatically increased the number of people with health insurance. As well as insurance companies recognizing the medical necessity of transgender care.

Choosing a surgeon for gender affirming procedures is one of the most important health decisions you’ll ever make!

But how many consumers are familiar with what questions to ask a potential surgeon? And how many doctors will actually volunteer important information regarding their experience? Or better yet, lack of?

Unfortunately, it’s hard to find reliable information about specific doctors or practices.

Even with access to the internet, reviews range from positive to negative. And for the same doctor! Asking around, subjectively different experiences are offered. Making it difficult to decide.

Still, there are strategies and resources that can help you find a gender affirming surgeon. Here’s what to focus on in your search and where to go for the information you need.

#1 CHECK IN WITH WHO’S WHO

If you know a gender affirming doctor (and if you are on HRT, you just might) or a gender specialist (hey, get my free exclusive list of CA providers), pick their brain!

Ask for the names of gender affirming surgeons in your area whom they like and trust. That can be more insightful than recommendations from friends or social media.

Think all medical providers just network together and refer people to one another? They don’t.

Why? Because referrals work the same way a boomerang does. If I recommend a solid doctor to you who is truly good, you will most likely recommend me. If I recommend a bad doctor, chances are you’ll never speak well of me again.

As a rule of thumb, not to mention as the ethically right thing to do, doctors and medical providers refer patients to those they trust.

#2 DO ASK PROFESSIONALS

I can’t stress enough how important it is to ask professionals for help! Take it from one.

When people email me with questions, I am more than happy to help. Thats because a person passionate about their work, will be passionate about helping others.

If you plan on getting a specific gender affirming procedure, look up specialist in that category. I highly recommend visiting my resource page where major doctors specializing in gender affirming surgery are listed by category.

Here is what you can do:

Email selected doctor. Better yet email two or three.
Ask if they know someone in your area to recommend.
Check out their website and see if they have a resource page listed. Anyone they recommend on there?

#3 ASK ABOUT THEIR TRAINING

The type of training your surgeon received is more important than the school they went to. Trust me!

Below are questions that will give you comprehensive background of just how solid their skills are.

Who the surgeon trained under?
The experience of that person?
What procedures the surgeon specializes in?
How long have they been practicing?

#4 WHAT IS THEIR EXPERIENCE?

While training is essential, experience is vital. Ask the surgeon:

How often has the surgeon performed the procedure you need?
Frequently or only occasionally?
Can they give you an approximate number of procedures performed?
When was the last time they performed the procedure?
Are they more specialized in feminizing or masculinizing procedures?
On a scale 1-10, how competent are they in their skill with specific procedures?

I highly recommend reading Is Your FFS Surgeon Craniofacial/Maxillofacial Trained? for a better understanding of experience necessary to perform gender affirming surgery.
NOTE: These are not inappropriate questions to ask!
Remember, you are a consumer and have the full right to inquire into your selected surgeon! In fact, a solid surgeon will be happy to answer your questions.

#5 WHATS THEIR TECHNIQUE?

The surgeon may have years of experience, but can lack in technique.

It is important for the surgeon to keep up with technical training especially with current advancements in the field.

Here are some vital questions to ask them:

Which technique do they prefer to use for the selected procedure?
Why?
Most importantly, ask why they use a certain technique (genital surgery and facial surgery a must) as opposed to other techniques?
Can they explain the benefits a using the technique they prefer?
How about the disadvantages of using the technique they prefer?

#6 DON’T OVERLOOK FUNCTIONALITY

Whether you are getting genital surgery, breast/chest surgery, or facial surgery, functionality is crucial.

Especially when it comes to genital surgery. Consider your sexuality.

As a trans man, trans woman, or nonbinary, ask how important is penetrative sex to you (or other sexual practices) and find out what you may need to obtain it.

Keep in mind, your sexuality can also change with time! Here are some things to consider:

Do you want your penis to be able to get erect?
Your vagina to have depth?
To pee standing up?
Is sensitivity important?
What about ability to reach orgasm?

#7 REMEMBER! APPEARANCE DOES MATTER!

You didn’t go to this length to not get the results you want.

While appearance may matter less to some, it can matter tremendously to others.

Make sure to ask:

Does the surgeon have any photographic examples of their work?
How many examples can they show you? One or twenty? The more the better.
If the surgeon is not local, can they send you photographs via email?
Do they have photos listed on their website?
Can they show you pictures of their most recent work?

#8 DON’T FORGET TO ASK ABOUT COST & INSURANCE

I don’t need to tell you that gender affirming surgery is costly.

While insurance plans will most likely cover genital surgery, few will cover chest/breast surgery, and even less facial feminization or masculinization surgery.

Thats why you want to drill them on the following questions:

Do they take your insurance?
Are they in network or out of network with your plan? This will drastically alter your expense.
Do you have a deductible or out of pocket maximum?
How much will be your financial responsibility, even with insurance?
If you plan to pay out of pocket, how much do they charge?
What their charges include? Hospital, surgery fee, anesthetist, surgery care kit, etc.? Make sure you know exactly how much you may have to pay!
If traveling overseas, do they provide accommodations?

#9 DON’T NEGLECT AFTERCARE

We are all busy beings with lives to get back to.

When it comes to gender affirming surgery, understanding what to expect post surgery is crucial.

So let’s be adults and inquire:

How long will you hospital stay be?
If traveling to another state, how long do you need to remain close to their practice for follow up?
What aftercare products you’ll need to buy?
Which aftercare products you will be provided with?
How long they want you to rest prior to returning to work?
How long prior to returing to other activities?
If you had genital surgery, ask them how long to wait prior to having intercourse of any kind.
Most importantly, what to look out for and who to contact in case of concerns/emergency?

#10 MAKE SURE TO LOOK UP TESTIMONIALS & REVIEWS

While highly subjective, testimonies and reviews are important. Especially places where people can list pictures for you to see.

Consider RealSelf or TransBucket for reviews of surgeons.
Search Facebook for specific groups devoted to gender affirming surgeries. They will most likely be closed private groups for a reason. Ask to be added to the group. Once you are in, ask others for recommendations.
Ask peers and friends who may have had the procedure you plan on getting.
Remember, people want to help and share information! But don’t forget to be mindful in how you ask.

#11 OUCH DO WATCH OUT FOR THESE RED FLAGS!

It can be easy to disregard red flags given your natural excitement in getting gender affirming surgery. Don’t!

They are there for a reason! Think of red flags like speed bumps. Slow down. Ask. Trust your feelings.

If your surgeon is unable to answer a majority of the questions listed above, that’s a red flag!
Can’t approximate how many procedures they performed? Red flag!
Don’t have any pictures? Red flag!
Incomplete answers or attempts at not answering your questions. Red flag!
Doctor doesn’t listen to you or your needs? Red flag!
Insists on a particular procedure without considering your thoughts on it. Red flag!
Malpractice claims or disciplinary actions. Red flag!
Majority of online reviews negative. Red flag!
Your gut feeling tells you something is off. Big red flag!
Make sure to watch: 4 Red Flags When Choosing a Gender Affirming Surgeon!

AND DON’T FORGET!

You are a consumer! You are paying for a service. As such, you have a right to inquire and ask questions. And a right to choose a doctor.

I say this fully knowing that gender affirming surgery in this country is a privilege and not a right!

Fully knowing very few can afford to pay out of pocket. And few have access to good commercial insurance plan.

Yet if we don’t inquire and ask questions about surgeon competency, we are not going to get the care we need.

DR Z PHD