Preparing For Surgery
When seeking surgery at the Center for Transgender Medicine and Surgery (CTMS), everyone is first seen by medical, social work, and mental health providers to plan for post-operative recovery and to make sure there are no problems that would make surgery unsafe. Our providers follow the World Professional Association for Transgender Health (WPATH) Standards of Care, Version 7 and can provide required letters before surgery. Visits to our pre-operative team, as well as the surgical consultation, must be completed in person.
CTMS providers will also review letters from other providers to make sure they meet the WPATH standards and will be accepted for insurance approval. They may ask for updated letters, or for different information to be included. CTMS medical providers are able to answer all questions about surgery at this initial appointment and help prioritize what to ask when speaking directly with the surgeon.
After these initial visits, the surgeon’s office will call to schedule a surgical consultation, when patients can discuss their preferences with the surgeon prior to surgery. This consultation visit can be scheduled within the same week as the initial medical, mental health, and social work appointments. However, such scheduling will require sending medical records to CTMS in advance of assigning appointment dates.
In order to ensure the best possible post-surgery results, CTMS targets a body-mass index of 33 or lower for phalloplasty, metoidioplasty, and vaginoplasty procedures. The program also requires that everyone be nicotine-free prior to surgery. For people with diabetes, hemoglobin A1C levels must be at 8.0 or lower.
CTMS also offers hair removal prior to vaginoplasty and phalloplasty procedures. This is highly recommended and will improve the post-operative outcome.
CTMS and the Mount Sinai Health System require pre-surgical testing, including a blood draw and a physical exam, within two weeks of your surgery date. This requirement is to make sure there are no immediate problems that will interfere with surgery.
Your Surgery Day
At each site, the Mount Sinai nursing staff helps you prepare for surgery. You meet with your surgeon, anesthesiologist, and several nurses who will ask questions to verify everything is in order. They will answer any questions you may have. Then, they bring you to the operating room, and the anesthesiologist puts you to sleep.
After surgery, all patients go to the post-anesthesia care unit. If the procedure requires an overnight stay in the hospital, we will take you to your hospital rooms.