Have a Surgical Consult

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

Some people do travel for in-person consults when possible or when required by the surgeon. If you cannot make a separate trip to Montreal, your surgeon will meet with you for an in-person consult a day or two before your surgery in Montreal.

  • GSP BC (Vancouver)
  • GRS Montreal

GSP BC (Vancouver)

The Surgical Consult

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 the process will include:

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
  • 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 a genital exam
  • assess need for medically necessary hair removal
  • take pre-op photos of the genitals if needed
  • determine if additional assessments or diagnostic tests are needed before proceeding

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
  • what to expect for aftercare in the months after surgery, including return to physical activity

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 consult and others may need to complete a few additional assessments first.

Closer to the time of your surgery, you may be booked an appointment with the Pre-Admission Clinic (PAC), which is a clinic that provides support for patients having surgery at VGH and UBC.

During this appointment, the nurses and anesthesiologists will review your health history, your current medications and your planned surgical procedure. You will also be reminded about instructions for before your surgery about diet and medications to take the day of surgery.

You will be given instructions about what to bring with you for this appointment. 

GRS Montreal

Some people do travel for in-person consults when possible or when required by the surgeon. If you cannot make a separate trip to Montreal, your surgeon will meet you for an in-person consult a day or two before your surgery in Montreal.

The Phone & In-Person Consult

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

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

The In-Person Consult

Each surgeon does things a bit differently, but generally the surgeon will:

  • ask questions about your gender, general health, and family history
  • examine the genitals to determine if there is enough tissue to do the surgery without an extra skin graft
  • check blood pressure
  • listen to your lungs
  • gently press on the abdomen and lymph nodes
  • take pre-op photos of the genitals
  • talk about possible surgical outcomes
  • give instructions for aftercare, including return to physical activity

Here are some tips on how to prepare for this appointment:

  • Attend a GSP BC Surgery Education Class
  • Read up on the surgery you are interested in:
  • Search online for before-and-after photos, including photos of people who have a body similar to your own
  • Have 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
  • Have a list of questions for the surgeon.
  • You can find both lists in The Workbook for Vaginoplasty and Vulvoplasty Surgery in BC, or you can click the support tool on this page.
  • Have a pen for taking notes.
  • 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 your surgical centre.

Frequently Asked Questions

What if the surgeon(s) recommends a type of surgery that is different from the one I want?

The surgeon 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. In some instances, the surgeon may recommend vulvoplasty instead of vaginoplasty.

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

If you would like to have a consult with another surgeon to explore other options, you can contact Trans Care BC. Booking a consult with another surgeon will require extra wait time.

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.

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.