Have a Surgical Consult

A surgical consult is an appointment with your surgeons to talk about your goals for surgery and your options in terms of procedures. It’s also an opportunity for you to ask questions.

GSP BC (Vancouver)

Tips for preparing for this consult:

  • Attend a GSP BC Surgery Education Class 
  • Read up on the surgery you are interested in-some resources include:
  • Search online for before-and-after photos, including photos of people who have a body similar to your own.
  • If there are any updates on your health since your initial referral was made, ask your GP or NP to send any relevant information to GSP BC.
  • Consider inviting someone to write notes so you can focus on the conversation.
  • Make a list of questions for the surgeon. You can find common questions in The Workbook for to Phalloplasty, Metoidioplasty and Erectile Tissue Release Surgery in BC.

What should I bring?

  • A pen for taking notes
  • A list of your current medications and supplements (including traditional medicines, such as herbs and teas; vitamins; minerals; amino acids; and probiotics). Include the dose and how often you take them
  • A list of questions for the surgeon.

Click this support tool to review both lists.

These lists are included in the Workbook for Phalloplasty, Metoidioplasty, and Erectile Tissue Release Surgery in BC.

What to expect from this visit

Before the appointment for your surgical consult, you will receive information about what to expect during this appointment. Sometimes you might have more than one appointment as part of this process. Each visit is a bit different, but generally you will:

Meet the nurse and have a detailed health history. The nurse might:

  • ask questions about your gender, general health, and family history
  • check blood pressure and heart rate
  • check height and weight
  • listen to your lungs, if needed
  • talk about what to expect from the rest of the process

Meet the surgeons and have a focused health history. The surgeons might:

  • ask more detailed questions about your health, if needed
  • ask about your hopes and surgical goals
  • do a physical exam, including checking the blood supply in your donor site 
  • do an internal genital exam (using a speculum to assess the genital depth and health of internal tissues)
  • assess need for medically necessary hair removal to donor site (for phalloplasty with urethral lengthening only)
  • take pre-op photos of the genitals, if needed
  • determine if additional assessments or diagnostic tests are needed

The surgical team will review the process of informed consent by helping you understand the:

  • recommended procedure,
  • details about the procedure,
  • potential benefits and risks of the surgery,
  • permanence of the surgery and how it affects fertility,
  • possible surgical outcomes,
  • possible need for revisions,
  • timeline for healing, and
  • what to expect for aftercare in the months after surgery, including return to physical activity.

You will also be shown a slide show about your surgery- this will include pictures of the surgery happening, and examples of post-operative results at different points of the healing process.

Next Steps

The next step is for the surgical team to initiate the process of filling out the OR Booking Package. This is done when someone is medically ready to proceed with surgery. Some people will fill out the OR Booking Package at their initial consult and others may need to complete a few additional assessments and have medically-necessary hair removal first.

Closer to the time of your surgery, you will be booked for an in-person appointment or phone call with the Pre-Admission Clinic (PAC), which is a clinic that provides support for patients having surgery at Vancouver General Hospital and UBC Hospital.

During this appointment, the nurse will review your health history, your current medications and your planned surgical procedure. You will be given information about any pre-op tests that are needed. You will also be reminded about instructions about diet and medications to take the day of surgery. You will spend time with the GSP BC nurse and health navigator to review the Enhanced Recovery After Surgery guide. This booklet will guide you through each step of the process and provide answers to common questions you may have.

Frequently Asked Questions

What if the surgeons recommend a type of surgery that is different from the one I want?

The surgeons will recommend the type of surgery that they think will provide you with the best surgical outcomes. Their recommendation is based on their extensive training, research, and experience.

If this is different from the surgery you want, let them know. This will lead to a conversation about the pros and cons of the different techniques as they apply to your goals.

I have been referred for an anesthesia consult. What does this mean?

Before surgery, you will be given anesthesia. Some health conditions can put you at higher risk for complications from anesthesia. In this case, your surgeon may refer you to an anesthesiologist for further assessment.

Having a consult with an anesthesiologist is a normal part of the surgical process for many people. We are all complex beings and some of us need more support than others. The purpose for anesthesia referrals is to make sure all measures are taken to keep you safe both during and after surgery. Because there are a number of different of anesthesia options, meeting with the anesthesiologist will help determine which one will best suit you and your health needs.

The anesthesia consult can be different based on the provider, but the doctor generally looks at a number of factors, including blood pressure, Body Mass Index and the presence of other medical conditions such as asthma or diabetes.

Depending on these factors, some patients with higher anesthetic risks may need to have surgery in a hospital operating room (rather than a private surgical centre) for safety reasons. In this case, having surgery in the US may be possible by applying to the Out-of-Country program. If appropriate, a qualified surgical specialist can complete an application for Out-of-Country Surgery. Clients can call Trans Care BC for more information.

Waiting and having challenges accessing surgery can be stressful. Many people find it helpful to connect with others who have gone through similar experiences. You might meet people who have had gender-affirming surgery through friends, support groups, or online networks.You may also find it helpful to talk to a counsellor during this time.

If you are experiencing challenges accessing surgery, or if you have questions about this process, call Trans Care BC.

What if GSP BC is not able to do my surgery?

If you are not medically eligible for surgery in BC, your surgical team will work with you to determine if other surgical centres may be an option. Clients can call Trans Care BC for more information.

How can I care for my mental health during the waiting process?

Waiting and having challenges accessing surgery can be stressful. Many people find it helpful to connect with others who have gone through similar experiences. You might meet people who have had gender-affirming surgery through friends, support groups, or online networks. You may also find it helpful to talk to a counsellor during this time.

If you are experiencing challenges accessing surgery, or if you have questions about this process, call Trans Care BC.