Your Consultation: What to Ask and Bring

By Nick Peplow·Gender-affirming surgery coordinator

Last reviewed 27 September 2026· How this site is researched

A consultation is the surgeon assessing you and you assessing the surgeon. Most people prepare for the first half and forget the second. I have sat in on a lot of these, and the most common regret afterwards is a question that never got asked because the time ran out.

Before you book it

• Fees. Some surgeons charge for the consultation and some credit that fee against the surgery if you go ahead. Ask when you book, not when the invoice arrives.
• Intake forms. Expect a questionnaire on your medical history, medications, height and weight, smoking, and time on testosterone. Many top surgery clinics also ask for chest photos, front and side, before a first video call, so the surgeon can see what they are working with.
• Paperwork they want first. Some surgeons will not see you without a letter of support or a referral; others take it later, or work on informed consent. Check which before you wait weeks for an appointment.
• Video or in person. Video is common for a first appointment, especially if you are travelling for surgery. The physical examination then happens in person, often a day or two before the operation. That means the plan can still change on the day, so ask what they would do if it does.

What happens in the room

Expect somewhere between twenty minutes and an hour. The order is fairly standard.

1. History. Medical history, medications, previous operations, any problems with anaesthetic, smoking, mental health, and your testosterone dose and route. Be straight with them. The surgeon is working out your risk, and a history left out comes back on the operating day.
2. Examination. For top surgery: chest size, skin quality and stretch, where the nipples sit, how much tissue sits out under the arms. For bottom surgery: a genital exam, how much growth you have had on T for metoidioplasty, and a look at the donor site for phalloplasty, including whether forearm hair removal is needed first. For facial work: photos and measurements, and sometimes a CT scan for bone work.
3. Their recommendation. Which technique, and why. For top surgery that means double incision, peri-areolar, keyhole or inverted-T; which technique explains what drives the choice.
4. Risks. Informed consent depends on this part, so it should not be rushed. Listen for the complication they call most common, not just the list.
5. Logistics. Wait time, price, what letters they need, blood tests, and any requirements on BMI or nicotine.
6. Your questions. Usually squeezed into the last five minutes. Have them written down and start with the ones that matter most.

What to bring

• Photo ID and any referral or insurance paperwork
• A list of every medication and supplement, with doses, including the testosterone preparation and when you last took it
• Your letters of support, if the surgeon needs them
• Anything relevant from past operations, especially any trouble with anaesthetic, nausea or clotting
• Recent blood results if you have them. A full blood count shows your haematocrit, which some surgeons check against a threshold for patients on T; see testosterone and surgery
• Your questions, printed or on your phone
• A notebook, or permission to record. Most surgeons agree if you ask first
• Someone else, if you can. The person who will look after you afterwards is the best choice; see the caregiver guide

If you smoke or vape nicotine, say so. It affects healing, most surgeons have a hard rule, and some test for it.

Questions worth asking

Choosing a surgeon covers what to weigh. These are the words to use in the room.

About them:

• How many of this exact procedure do you do a year?
• What is your revision rate, and what counts as a revision in that number?
• What is your most common complication, and how do you handle it?
• Can I see results on bodies like mine, at a year rather than six weeks?

About the procedure:

• Which technique do you recommend for me, and what would make you choose differently?
• What will the scars look like at a year, and where will they sit? For top surgery, see scars.
• What do you expect for sensation?
• If I am unhappy with symmetry or contour, what happens next?

About recovery:

• When can I lift my arms overhead, drive, go back to work, exercise?
• Will I have drains, and for how long?
• Who do I contact out of hours if something looks wrong, and how fast do they answer?
• How many follow-ups, and can any be done remotely?

About money and paperwork:

• What does the quote include? Surgeon, anaesthetist, facility, nights in hospital, garments, medication, follow-ups.
• What is the deposit, and what is refundable if I postpone or you cancel?
• If I need a revision, who pays, and within what time limit?

What a good answer sounds like

The words matter less than how easily they come. A surgeon who answers the revision question with a figure and says what it counts has done the sum before. "Very few, it's rare" is not a number.

The same goes for technique. A good surgeon will tell you why they would not do the other options on your chest. If only one technique is ever offered, ask whether they do the others at all.

Warning signs

The consultations I remember going badly had a pattern: pressure to pay a deposit on the day, no figure on volume or complications, questions about scars, sensation or revision brushed off as worry, and nobody able to say who answers the phone after the operation. One of these on its own does not make someone a bad surgeon. Two or three are a reason to get another opinion before you commit. The full list is under red flags on choosing a surgeon.

Afterwards

Write up your notes the same day, including anything that contradicted what you had read. Ask for the quote and the plan in writing; a verbal price is not a price. If you see more than one surgeon, put their answers side by side. Where two surgeons disagree is usually where the real decision sits, and it is a good question to take back to either of them.

If you are thinking about more than one operation, raise it here rather than later; combined procedures has the questions for that. Once you have a date, work through the pre-op checklist.

This is information, not medical advice. The surgeon has your history and your body in front of them; this page does not.