Planning Your Surgery

By Nick Peplow·Gender-affirming surgery coordinator

Last reviewed 27 September 2026· How this site is researched

Between deciding on surgery and being on the table there are usually several months of practical work. You pick a surgeon, sit through a consultation, sort out hormones and fertility, book time off, pack, and line up someone to look after you. This section takes those in roughly the order they come up. Most of the avoidable problems I have seen came from one of these steps being left to the last fortnight.

Before you book

The biggest decision is choosing a surgeon. That page is about how to judge one: how often they do your exact operation, how they show results, whether they will define their revision rate, and who answers the phone at week three. It is not a shortlist, and I do not rank surgeons. The consultation page covers the appointment itself: what the surgeon examines, what to bring, the questions to ask in the room, and what a straight answer sounds like next to an evasive one.

If you want more than one procedure, read combined procedures before the consultation. Top surgery with a hysterectomy under one anaesthetic is the pairing I see booked most, and it can save a block of time off and a facility fee. Some pairings are routine and some are not, and the page says which. Sequencing across several years is on which surgery first.

Hormones and fertility

Two things need sorting months ahead, not weeks. Fertility preservation has to happen before a hysterectomy with oophorectomy, and egg or embryo freezing has often meant pausing testosterone for a month or more first, so it needs planning around your surgery date. Surgeons should raise it before any operation that removes the ovaries; in the consultations I have sat in on, not all of them do.

Testosterone and surgery covers whether you will be asked to pause T. Surgeons disagree about this more than about almost anything else, and the page explains what the disagreement is about. It also covers the pre-op blood test that matters most if you are on T, so you can raise it early.

Getting ready

The pre-op checklist runs week by week through the run-up: tests, medications to stop, paperwork, time off and getting the house ready. The packing list is what to take to hospital and what to have waiting at home.

If you are travelling for surgery, whether to another city or another country, that page covers how long to stay before flying, where to recover, and how follow-up works once you have gone home. That last part is the one to settle before you book the flight.

The caregiver guide is written for whoever is looking after you. Send it to them before surgery. It covers what they will actually be doing, from emptying drains and tracking medication to spotting the signs that mean calling the clinic, so you are not explaining it all on painkillers.

What this section is not

This is information, not medical advice, and it does not override your surgeon's instructions. The ranges on these pages are for planning; the figure your surgeon gives you overrides them. Costs have their own section under costs, and what happens after the operation is under recovery.