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Surgical consultations

What is a surgical consultation?

This is a first appointment with a surgeon to give you an opportunity to:

  • explain your situation - like your medical conditions and medications
  • indicate what you want from your surgery - see below for things you might request
  • ask the surgeon questions - there are suggested questions on this page
  • learn more about the surgery - including options and risks
  • receive paperwork - like documents to read over before your surgery
  • agree to the surgery - this is called giving your consent, but you can still change your mind later

You should always have a surgical consultation before any gender surgery to make sure you are fully prepared for the surgery and that surgeon agrees you are ready to proceed.

What happens in a surgical consultation?

You will meet with a member of the surgery team, and often a senior nurse from the surgery team, at their offices. You will have a conversation about the surgery with the surgeon where you can ask each other questions.

The surgeon may ask if you are currently smoking, vaping, or using nicotine products, as these may affect your recovery.

In this consultation, the surgeon may also ask you to:

  • show them the part of your body that will be operated on: his might be very uncomfortable for you, but it is generally very brief, and done in a private and clinical way.
  • touch this part of your body: or may ask you to move it so that they can more clearly examine your body.
  • allow them to take photos of that part of your body: this is for your medical records and may be used for surgical planning. You may be asked for your consent for the anonymised photos to be used for patient education, staff education, and potentially for publication. It is your choice whether to give this consent or not.
  • weigh your body: as some surgeons may require you to have a certain BMI index.
  • provide a urine sample: this can be used to test you for particular medical conditions.
  • use a test swab: this is a small stick covered in fabric which you may be asked to rub on a part of your body, which may be your genitalia or anus, and can also be used to test you for particular medical conditions.

Remember that if you would feel more comfortable with a friend, family member, or another person present, you are allowed to ask for this.

After your consultation you are still free to change your mind and decide not to have surgery, or to switch to a different surgeon or surgery team.

What questions can I ask during my surgical consultation?

Some common things you might want to ask your surgeon about are:

  • What do I need to do before the surgery?
  • What complications (problems after the surgery) may happen?
  • What are the risks of complications happening? What can be done if they happen?
  • Would my medical conditions or medications affect my surgery or recovery?
  • How long will I be in the hospital?
  • How does discharge (leaving hospital) work?
  • What do I need to do when I get back home?
  • What should I expect during my recovery?
  • What should I look out for after the surgery?
  • What do I do if an emergency happens at home?
  • How soon can I go back to work, exercising, or playing sports?
  • Will I need to come back to see the surgery team again? When?

If you are paying for the surgery yourself, you might also ask:

  • Can payments be made in instalments or on a payment plan?
  • What additional costs might I need to pay in addition to the surgery fee?
  • If I need revision surgery, would this be at extra cost?

If you have any any other worries or concerns, this is the time to ask about them.

Surgical consultations can be stressful, so if you are worried about remembering things, you might want to ask if you can take written notes. You might also find it helpful to take a list of questions with you so that you don’t forget to ask something.

You might think of more things you want to know after your surgical consultation has finished. You can email your surgery team to ask these questions, or if you would like, you can ask for another surgical consultation to ask further questions so that you are sure before you make the final decision.

What can I ask my surgeon for?

An important part of your surgical consultation is that it gives you an opportunity to explain to your surgeon what you would like your results to be like. We have put some suggestions of things you could ask for on this page, but if something in particular is important to you, ask whether it is possible or not. Surgeons may be open to unexpected requests, and it may be helpful to have at least explored ideas with the surgeon, so that you do not regret not asking later.

A good way to explain to a surgeon what your preferences are is to use pictures. This might be, for example, pictures of other people’s chests, or of surgery results you have found that look like what you want.

If you are having a chest surgery, you might want to indicate if you have preferences whether:

  • nipple size is large or small
  • nipples are retained or not
  • scars join in the middle or not
  • to prioritise hiding scars, or instead to make as flat as possible
  • to prioritise nipple sensation, appearance, or reducing risks

If you are having a feminising lower surgery, you might want to indicate if you have preferences whether:

  • appearance, reducing risks, or maintaining sexual function is your priority
  • amount of depth of the vaginal canal is important to you or not
  • a more natural looking appearance or something smooth is what you want

If you are having a masculinising lower surgery, you might want to indicate if you have preferences whether:

  • appearance, reducing risks, or maintaining sexual function is your priority
  • ability to have vaginal sex is maintained
  • ability to penetrate your partner with your genitalia is required
  • standing to urinate will be possible or not

Where can I learn more?

There are more ideas for questions you might ask in your consultation on this article on the Dillon Marshall Cowell website.

You can also speak to NHS Gender Dysphoria National Referral Support Services (GDNRSS) to discuss how to make best use of an NHS surgical consultation. You can contact the service by calling 01522 85 77 99 or by email. The service is open Monday to Friday from 9am until 5pm. You can find out more about the service in this booklet.

What do I do next?

Once you’ve had your surgical consultation, you might want to start preparing for your surgery. You can find a useful guide on doing that on our Getting ready for gender surgeries page.

If you decide that you would prefer to use a different surgeon, you can contact NHS Gender Dysphoria National Referral Support Services (GDNRSS) to arrange this, though you may find that you have to wait additional time to access the new surgeon.


This page is illustrated using a photograph by Alex Green available at Pexels.

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