Six questions to start with#

If you are reading on a phone or have limited appointment time, copy these into a note and use the longer sections only for your procedure. They are questions to ask, not claims about what every surgeon or operation does.

Which exact procedure and components fit my goals, and what alternatives should I consider?
What outcomes are realistic for my anatomy and health, and what will remain uncertain?
What are your own complication and revision rates for this procedure, over what period, and how do you count them?
Who will answer urgent questions or treat a complication after discharge, including if I travel home?
What will I need to do before and after surgery, and which instructions are specific to me?
What will I pay for the procedure, follow-up, and a possible revision under my plan or self-pay estimate?

Use Compare Procedures for option trade-offs and Caregiver Quick Reference to record your discharge contacts later. Write the answer in your own words, then ask the team for its written version where decisions depend on it.

Universal Questions (All Procedures)#

Surgeon Experience and Credentials#

Question	Answer/Notes
How many of this specific procedure have you personally performed?
What is your training in gender-affirming surgery?
What training and credentials apply to this exact procedure, and how can I verify them?
How many of these procedures do you perform per year?
What are your complication rates for this specific surgery?
What is your revision rate?
How do you define "complication" versus "revision" versus "expected variation"?

About My Specific Situation#

Question	Answer/Notes
Do you have concerns about anything in my medical history?
What are the specific risks for someone with my health profile?
How often do you operate on patients at my BMI?
How often do you operate on patients in my age range?

Surgical Approach#

Question	Answer/Notes
What procedure and optional components do you recommend for my goals and anatomy?
Why this approach over alternatives?
Can I see consented before-and-after photos of patients with anatomy similar to mine?
Can I see results from multiple healing stages (not just final results)?

Complications and Follow-Up#

Question	Answer/Notes
What are the most common problems patients experience?
Who evaluates and treats a complication, including after hours or after I return home?
How quickly can patients be seen if problems emerge?
What does your follow-up schedule look like?

Logistics#

Question	Answer/Notes
Where will surgery be performed (ASC, hospital, academic center)?
Do you have hospital privileges? At which hospital?
What's included in the quoted surgical fee?
What's your revision policy and timeframe?
If I need a revision, what costs am I responsible for?

Vaginoplasty-Specific Questions#

Technique and Depth#

Question	Answer/Notes
What vaginal depth can I expect with your recommended technique?
What are the tradeoffs between penile inversion, peritoneal pull-through, and colovaginoplasty for my anatomy?
Is my tissue amount adequate, or would supplemental grafts be needed?
Will the procedure involve any hair-bearing tissue?

Dilation#

Question	Answer/Notes
What is the typical dilation schedule?
How intense is dilation during the first three months?
How long does the dilation commitment continue?
Can regular intercourse substitute for dilation?
What happens if I miss sessions?

Hair Removal#

Question	Answer/Notes
What areas need hair removal?
When must hair removal be completed (12-18 months before)?
Should I use electrolysis, laser, or both?

Hormones#

Question	Answer/Notes
Should I stop estrogen before surgery? For how long?
When should I stop anti-androgens?
Do I have risk factors (clotting history, genetics, smoking) that affect this?

Vulvoplasty-Specific Questions#

Question	Answer/Notes
Do you offer vulvoplasty specifically, or only vaginoplasty?
What is your vulvoplasty-specific volume and outcomes?
Do you create true zero-depth or minimal-depth? If minimal, what depth?
Do you use a one-stage or two-stage approach?
What is your revision rate for vulvoplasty specifically?
Is later conversion to vaginoplasty possible with your technique?
Can I see vulvoplasty-specific before-and-after photos?
Can I connect with previous vulvoplasty patients?

Phalloplasty-Specific Questions#

Donor Site#

Question	Answer/Notes
What donor sites do you offer?
Which do you recommend for me, and why?
What are the tradeoffs between sensation and visible scarring for each?
(If forearm) Have you verified via Allen test that my ulnar artery can supply my hand?
(If thigh) What is my body fat thickness? Am I a candidate for single-stage?

Urethral Lengthening#

Question	Answer/Notes
What is your fistula rate?
What is your stricture rate?
What are the success rates with versus without vaginectomy?
If urethral lengthening fails, would perineal urethrostomy be acceptable?

Erectile Devices#

Question	Answer/Notes
What are your infection and revision rates for device implantation?
Which device do you recommend and why?
What is your anchoring technique?
What are my options: inflatable, semi-rigid, or external prosthetics?

Staging#

Question	Answer/Notes
What is your staging approach? How many stages?
What is the typical timeline between stages?
What happens at each stage?

Metoidioplasty-Specific Questions#

Question	Answer/Notes
Do you offer simple metoidioplasty (clitoral release only)?
What is my candidacy for simple versus comprehensive metoidioplasty?
What neophallus length can I realistically expect?
Can you pre-operatively measure my clitoral length?
Will nerve preservation be performed?
Will orgasm remain possible?
Will I achieve natural erections?
Can I use PDE5 inhibitors (Viagra, Cialis) if needed?
(If considering urethral lengthening) What is your standing urination success rate?
What technique do you use (Belgrade, ring, other)?
Will scrotoplasty be performed? When will testicular implants be placed?
What implant sizes are available?
(If preserving vaginal function) What are my options?

Orchiectomy-Specific Questions#

Question	Answer/Notes
Do you perform standalone orchiectomy for gender affirmation (not just as part of other procedures)?
What is your specific experience with this procedure?
What is your approach to sensation preservation?
If I desire erogenous tissue preservation, what are my options?

Facial Surgery-Specific Questions#

Question	Answer/Notes
What specific procedures do you recommend for my face, and why?
What will these procedures accomplish?
What about my facial structure will remain similar regardless?
What are the limitations given my anatomy?
Will you address bone structure or only soft tissue?
Where will incisions be made?
What scarring should I realistically expect?
Can I see results at 6 weeks, 3 months, 6 months, and 12 months?
Do you have BMI limits? Will you work with me with appropriate precautions?

Nulloplasty-Specific Questions#

Goals and Approach#

Question	Answer/Notes
What nerve preservation options do you offer?
Do you offer buried glans, surface glans, or complete removal?
How will the urethral opening be positioned?
Where will incisions be, and what will scarring look like?

Experience#

Question	Answer/Notes
How many nulloplasty procedures have you personally performed?
What is your complication rate for this specific surgery?
How many of your nulloplasty patients have needed revision surgery?
Can you show me photos of results at various healing stages?

Recovery and Function#

Question	Answer/Notes
What does recovery look like week by week for the first three months?
How will urination work post-operatively?
What should I expect during the learning curve?

Voice Surgery-Specific Questions#

Question	Answer/Notes
What is my speaking fundamental frequency now, and what can surgery achieve?
Which surgical technique do you recommend and why?
What are your specific complication rates?
What about my voice will NOT change with surgery (resonance, intonation)?
Will my voice sound natural or artificial/surgical?
How will surgery affect my singing voice?
What are the trade-offs (reduced volume, narrowed frequency range)?
Do you recommend voice therapy before, after, or alongside surgery?

Pre-Op Questions (All Procedures)#

Question	Answer/Notes
What medications should I stop before surgery, and when?
Should I continue hormones through surgery?
When should I stop eating and drinking before surgery?
What should I have prepared at home for recovery?
How long do I need a caregiver?
What supplies should I have on hand?

Post-Op Questions (All Procedures)#

Question	Answer/Notes
When can I return to work (desk job vs. physical labor)?
When can I resume exercise?
When can I resume sexual activity?
What sleeping positions should I use?
What are the warning signs that something's wrong?
When should I contact you versus wait for my next appointment?
Can I fly after surgery? When?

Choose the questions that matter to your goals. Bring a short list to the consultation and record the answers, date, and any written follow-up promised.

Continue exploring#

Links to outside sources open in a new tab. Full references, where used, remain in the article.

Question	Answer/Notes
What technique do you recommend for my chest size, skin elasticity, and goals?
Am I a candidate for keyhole, periareolar, double incision, or inverted-T?
What are the tradeoffs between these regarding scars and sensation?
(If I've bound) How has binding affected my skin elasticity and technique options?

Question	Answer/Notes
What are my options for nipple preservation versus grafting?
What sensation can I expect with each approach?
If graft failure occurs, what are my reconstruction options?
(If desired) Is no-nipple surgery an option?

Question	Answer/Notes
Have you performed non-standard/nonbinary chest surgery before?
Can you show me photos of non-flat results?
Are you comfortable with the specific outcome I'm describing?
Do you have experience with controlled tissue retention or asymmetrical results?

Questions for a Surgeon