Explore the field.
Start with a question, procedure, or story. You can also filter every topic below.

Three short introductions. Choose what helps today.
- Start Here
Find a grounded way into the guide and choose a path that fits your questions.
- Understanding Dysphoria
Explore dysphoria as a personal experience rather than a test you must pass.
- Embodiment and Euphoria
Make room for comfort, recognition, and joy alongside dysphoria.
- Body Parts and Identity
Separate questions about anatomy from the full meaning of your identity.
- Trans Myths
Recognize common myths and return to evidence, context, and lived reality.
- Hormone Therapy
Understand the questions hormone therapy may raise alongside surgical planning.
- Procedure Options
Compare broad pathways by the outcomes and tradeoffs that matter to you.
- Plan Your Surgery
Turn a large decision into manageable questions, tasks, and conversations.
- U.S. Insurance, Costs, and Documents
Organize coverage, cost, and paperwork questions in a changing U.S. care context.
- Fertility
Consider fertility and reproduction questions before decisions become time-sensitive.
- Accessibility and Planning
Plan for disability, neurodivergence, communication, and other access needs.
- Choose a Surgeon
Evaluate fit, communication, experience, logistics, and your own priorities.
- Nulloplasty
Understand goals, approaches, and planning questions for nulloplasty.
- Vaginoplasty
Compare vaginoplasty approaches, goals, and questions for consultation.
- Vulvoplasty
Learn how zero-depth vulvoplasty differs from procedures that create a canal.
- Orchiectomy
Explore orchiectomy goals, timing, and its relationship to other care decisions.
- Penectomy
Understand penectomy in relation to different surgical goals and pathways.
- Phallus-Preserving Vaginoplasty
Explore a pathway that may combine vulvar anatomy with phallus preservation.
- Hysterectomy and Oophorectomy
Understand choices involving the uterus and ovaries within a larger care plan.
- Metoidioplasty
Learn the goals, variations, and planning questions for metoidioplasty.
- Phalloplasty
Explore phalloplasty goals, donor-site questions, and staged planning.
- Phalloplasty vs. Metoidioplasty
Compare two pathways by goals, tradeoffs, recovery, and staging questions.
- Facial Surgery
Explore facial feminization, masculinization, and the questions behind an individualized plan.
- Top Surgery
Compare chest surgery goals, approaches, and preparation questions for different bodies.
- Voice Surgery
Learn how voice surgery and modification fit into broader voice goals.
- Recovery Emotions
Make space for changing expectations, dysphoria, relief, and uncertainty during recovery.
- Recovery Essentials
Build a practical recovery plan around supplies, routines, support, and communication.
- For Caregivers
Understand the practical and emotional work of supporting someone through surgery.
- Documenting Healing
Use notes, photos, and reflections in ways that serve your own recovery.
- Intimacy After Surgery
Approach sexuality, intimacy, communication, and a changing body at your own pace.
- Thriving Long-Term
Carry recovery forward into a life shaped by your values, relationships, and goals.
- International Care
Plan for travel, communication, follow-up, and care across borders.
- U.S. Care Context
Understand the changing access, policy, and practical context around care in the United States.
- Care in Canada
Explore Canada-specific access and planning context for gender-affirming care.
- Care in Mexico
Explore Mexico-specific access and planning context for gender-affirming care.
- Care in the United Kingdom
Explore United Kingdom-specific access and planning context for gender-affirming care.
- Care in France
Explore France-specific access and planning context for gender-affirming care.
- Care in Germany
Explore Germany-specific access and planning context for gender-affirming care.
- Care in the Netherlands
Explore Netherlands-specific access and planning context for gender-affirming care.
- Care in Spain
Explore Spain-specific access and planning context for gender-affirming care.
- Care in Italy
Explore Italy-specific access and planning context for gender-affirming care.
- Care in Turkey
Explore Turkey-specific access and planning context for gender-affirming care.
- Care in Thailand
Explore Thailand-specific access and planning context for gender-affirming care.
- Care in Japan and South Korea
Explore Japan- and South Korea-specific access and planning context for gender-affirming care.
- Care in Australia and New Zealand
Explore Australia- and New Zealand-specific access and planning context for gender-affirming care.
- Axl's Story
Read one person’s path to nulloplasty as lived experience, not a template.
- Pre-Op Nullo Q&A
Read pre-operative questions and answers in their personal context.
- Axl's 2024 Journey
Follow a personal 2024 nulloplasty journey in its own words and context.
- Post-Op Nullo Q&A
Read one person’s reflections one year after nulloplasty.
- Community Roundtable
Read a community conversation about bodies, identity, and life after surgery.
- About This Guide and Download
Learn how this guide is organized and how to use the complete book.
- Recovery Toolkit
Gather practical lists and trackers for preparing for recovery.
- Questions for a Surgeon
Bring a focused, adaptable question list to your consultations.
- Planning Documents
Use checklists and planning documents to keep decisions and records organized.
- Caregiver Quick Reference
Keep practical caregiving tasks and communication needs close at hand.
- International Packing
Build a packing plan for surgery-related travel and recovery away from home.
- Insurance Appeal Starter
Start organizing an appeal with a template you can adapt to your situation.
- Letters of Support
Understand how procedure-specific support-letter requests may be organized.
- Glossary
Find clear definitions for terms used throughout the guide.