Get A Surgical Readiness Assessment

You will meet with a Qualified Surgical Assessor for a Surgical Readiness Assessment. The Surgical Readiness Assessment confirms that you meet the criteria for publicly-funded Vaginoplasty or Vulvoplasty. It also helps ensure you are prepared and supported before, during, and after your surgery.

Many people feel anxious about the Surgical Readiness Assessment. They worry about saying the wrong thing and being denied a surgery that is very important to their health and well-being.


These assessments have changed as understandings of gender and human rights have evolved. The focus of the assessment should be on supporting you. To learn more about questions you might be asked in an assessment, checkout the Common Surgical Readiness Assessment Questions in the FAQ section below.

Together, you and the assessor will discuss your gender, your health, your support people, and details about the surgical procedure.

After the appointment, the assessor will write a recommendation for surgery based on the criteria for approval and the information you’ve shared with them.

The assessor will send their recommendation to your doctor or nurse practitioner, who will send your completed referral package to the surgical clinic of your choice: the Gender Surgery Program of BC (GSP BC) or GRS Montreal. At this time, you can be referred to both surgical centers. Your name will then be added to the clinic’s surgical waitlist.

The referral form for the Gender Surgery Program of BC can be found on their website.

A list of documents that must be included in a referral to GRS Montreal can be found here.

  • Brief referral letter from GP or NP. Include any relevant clinical details not covered in the surgical recommendation form, e.g.,
    Body Mass Index
  • Copies of the surgical recommendation form(s) (Form A and Form B) or equivalent narrative letters 
  • Any relevant consult reports (e.g. recent cardiology, endocrinology reports)
  • Consent to exchange information between GRS Montreal and Trans Care BC (if applicable, this will be attached to the recommendation forms)
  • Consent to exchange information between GRS Montreal and GP/NP (if applicable, this will be attached to their commendation forms).

Once your surgical program receives all required documents, your name will then be added to their surgical waitlist.

Frequently Asked Questions

What are the criteria for publicly funded Vaginoplasty or Vulvoplasty surgery?

The criteria for Vaginoplasty or Vulvoplasty are guided by the World Professional Association for Transgender Health’s most current
Standards of Care. In British Columbia, the criteria are:

  • Persistent gender dysphoria
  • Age 18 years or older
  • Ability to understand and consent to the surgery
  • One year of hormone therapy
  • Physical and mental health conditions are reasonably well-managed.
  • One year of living in a way that is aligned with your gender. This means that you are actively expressing your gender in your daily life – it does not mean that your gender expression has to conform to the gender binary or a stereotype

What kind of questions will the assessor ask?

The assessor may ask questions…

… about your gender:

  • What pronouns do you use?
  • How would you describe your gender?
  • When did you start living outwardly as yourself?
  • How long have you been thinking about gender-affirming treatment?

…about your physical and mental health:

  • Have you ever been diagnosed with a physical health condition?
  • Have you ever been diagnosed with a mental health condition?
  • What is your height and weight?
  • What medications are you on?
  • Have you had any surgeries before? Did you receive anesthesia? Did you have any problems with it?

…about your support people:

  • Who are your main support people? Will they be able to help you after surgery?
  • Do you have a GP or NP, and are they supportive?
  • Is there anything you think would be important for me to know to help with your care planning?

Here is a downloadable list of common question that you may be asked, during a readiness assessment for gender-affirming surgeries.

What do I need to know to make an informed decision about getting surgery?

It’s important to understand the following information:

  • details related to the procedure,
  • potential benefits and risks of the surgery,
  • permanence of the surgery and how it affects fertility,
  • possible need for revisions,
  • timeline for healing, and
  • what to expect for aftercare in the months after surgery.

Your assessors and your surgical team will help you understand these details. You should ask them any questions you have. To learn more about the procedure, see GRS Montreal’s website:

  • Vaginoplasty
  • Vulvoplasty 

Rainbow Health Ontario has excellent Transition-Related Surgery information too:

  • Vaginoplasty

I don’t identify as feminine or female. Can I still get Vaginoplasty or Vulvoplasty?

Yes.The most current WPATH Standards of Care support access to Vaginoplasty or Vulvoplasty for people who have a non-binary gender and/or people who do not dress or identify as feminine or female

I have a non-binary gender. Can I still get Vaginoplasty or Vulvoplasty?

Yes. The most current WPATH Standards of Care support access to Vaginoplasty or Vulvoplasty for people who have a non-binary gender and/or people who do not dress or identify as feminine or female. 

I am Two-Spirit and seeking gender-affirming surgery. Can I still get Vaginoplasty or Vulvoplasty?

Yes. The most current WPATH Standards of Care support access to Vaginoplasty or Vulvoplasty for people who are Two-Spirit and seeking gender-affirming surgery.

How long will the assessment take?

Surgical Readiness Assessments are usually completed in two sessions (one with each assessor), but it is sometimes possible to have them done at the same time (one session with two assessors). An assessment lasts for 1-2 hours and there is no physical exam. Extra visits may be booked for individuals that need extra support.

What happens if the assessor(s) decide I’m not ready for surgery?

If there are areas of your health or well-being that need attention to make sure you recover safely after surgery, the qualified surgical assessors will recommend that you make a plan with your doctor or nurse practitioner to address them. This can include managing acute or chronic health conditions, getting help with housing, or finding mental health supports that you may not already have.

This does not mean you will be denied surgery. Instead, you will be presented with ways you can work towards a safer surgery and recovery. By addressing these areas, you start your healing process before your surgery and reduce the chances of having complications.