Preparing for surgery

Your health care team (your surgical team and primary care provider A person’s main health care provider in non-emergency situations such as check-ups and referrals. Family doctors, general practitioners (GPs) and nurse practitioners (NPs) are all primary care providers. ) should be your first source of information on preparing for surgery — they have information that is most relevant to your unique situation. 

Consult with your health care team

When you have your surgical consult at the Gender Surgery Program B.C., you’ll learn what you can do to prepare for surgery, what to expect during the healing process and how long it will likely take to recover.

GSPBC will support your preparation as follows:

• You will meet with a GSPBC social worker, who will work with you to see whether or not you could benefit from additional support preparing for surgery, help you establish a plan for travel, accommodation and post-surgery support. 
• You will also check in with the GSPBC pelvic floor physiotherapist for an assessment and ongoing support as needed. 
• When a surgical date is offered to you, you will receive further education on your surgery. 
• Finally, you will receive the Enhanced Recovery After Surgery (ERAS) booklet and a nurse will review this with you. 

Create a self-care plan

To supplement guidance from your health care team, we’ve compiled information on how to create a self-care plan. 

Self-care plans are a proven method for managing the wide range of emotions and physical ups and downs that you might experience after surgery. This type of plan requires you to do some work before your surgery, but the more you prepare, the smoother your recovery experience will be.

Here are some of the things a thorough self-care plan will include.

Prepare your body

Research shows that physically preparing for surgery helps improve outcomes. Here are some ways you can prepare your body to heal well after surgery. 

• Stay active — Simple exercises will build strength and support your heart and lung health. Dog walking, dancing, hiking, stretching or weight training are good examples. 
• Enjoy foods that promote healing — Choose foods that will help your body heal faster. Look for foods that contain protein (meats, fish, nuts, some dairy); zinc (whole grains, spinach, nuts); vitamin A (carrots, broccoli, eggs); and vitamin C (citrus fruits, strawberries, peppers). Don’t forget to drink enough water. Your urine should be clear or light yellow.
• Rest up — Get 7–9 hours of sleep each night and take time to slow down and relax. If you have trouble sleeping, speak with your primary care provider about strategies for better sleeping. 
• Stop nicotine use — Nicotine use (including smoking) interferes with your body's ability to heal and can cause complications following anesthesia and surgery. This is why doctors recommend avoiding cigarettes before and after surgery. If avoiding smoking for 2–3 months seems extremely challenging for you, speak with your primary care provider or check out the B.C. Smoking Cessation Program where you can get supplies to help you quit. (These supplies are covered by MSP The Medical Services Plan (MSP) is a B.C. government health plan that pays for physician services and referred services that are considered medically necessary, such as specialists (surgeon, psychiatrist, etc.), diagnostic x-rays, or laboratory services, for all BC residents. Some residents qualify for premium assistance for physiotherapy, chiropractic, naturopathy, massage therapy and acupuncture. and are available at any B.C. pharmacy.) 
• Avoid substance use — If you smoke cannabis and going 2–3 months without it will be hard for you, consider switching to edibles, concentrates or tinctures. Other substances like methamphetamines, cocaine, heroin and alcohol also disrupt the healing process. If you need help avoiding these substances, contact your primary care provider. 
• Optimize your health — If you have any chronic health conditions, optimize your health. This may include controlling blood sugar (if you have diabetes) or improving anemia (if you have low iron). Good iron stores will allow you to heal better and have more energy when you go home. Maintaining blood sugar helps with healing after surgery.
• Minimize the risk of infection — There are things you can do to reduce the risk of infection and surgery cancellation. Wear a high quality mask, ensure you have up-to-date influenza and COVID-19 vaccinations with boosters. You also can request COVID-19 testing and masking before visiting with others. 

Prepare emotionally

Gender-affirming surgery is a big deal! Experiencing a wide range of emotions, from excitement and relief to anxiety, self-doubt and depression, is very common.

If you’re someone without a strong support network, it’s important to work to develop these connections as a part of preparing for surgery. However, there is a lot you can do to prepare in advance, and you can arrange logistical support (like grocery or meal delivery and hospital transfers). For more examples of some things you might need support with, see Arrange Support.

Many people find they experience a low mood for a period of time following surgery. You can prepare for these “blues” by jotting down the answers to the following questions and sharing that information with people close to you. 

• What does it look like when you start to feel low?
• How will people know that you're feeling that way?
• How do you like to be supported when you're feeling that way?

Beyond your own personal support network, here are some additional sources of support:

• Peer support groups — Having people to talk to about your experiences and feelings can be very helpful. Visit our Peer Support Directory to find the group for you. 
• Mental health experts — Many people find it helpful to talk to a counsellor. Check out our information on Finding a Counsellor.
• Community support — Are there people in your community, such as mentors, Elders or religious leaders you can connect with?
• Personally meaningful activities — Stock up on items you might use for activities such as arts, crafts, sketching or ceremonial practices (for example, smudge or dry brushing).
• Trans Care BC — If you’d like help connecting with counselling or peer support, feel free to contact Trans Care BC’s health navigation team at any time along the way.

Prepare for costs

It’s a good idea to be prepared for the costs associated with surgery. MSP pays for most of the costs associated with your penis construction An umbrella term for gender-affirming genital surgeries that create a penis, including erectile tissue release, metoidioplasty and phalloplasty. surgery, but there are other costs you should consider, including: 

• Time off from work — You will need time off for both your surgery and recovery period. Recovery times are unique to each person, but here are rough guidelines for the initial surgery:
  • Erectile tissue release This procedure creates a penis by cutting the ligaments around the erectile tissue (clitoris), so the shaft falls away from the body, giving it a more pronounced appearance. : 3–6 weeks
  • Metoidioplasty A gender-affirming lower surgery to create a penis. Metoidioplasty involves cutting ligaments around the clitoris to add length to the shaft and grafting skin around the shaft to create more girth. Optional additional procedures include scrotoplasty and urethral lengthening. : 6–8 weeks
  • Phalloplasty A gender-affirming lower surgery to create a penis and scrotal sac (phase 1) followed by testicular implants and implants to obtain rigidity/erection (phases 2 and 3). : 6 weeks – 6 months (depending on the complexity of the procedure and complications)
• Medical supplies and other post-surgery items — These include wound care supplies, supportive garments and medications. You can find a full list of recommended post-surgery items in the Phalloplasty, Metoidioplasty, Erectile Tissue Release Workbook.
• Travel and accommodation — If you don’t live near Vancouver General Hospital, you will need to cover the costs of travel. You may want to arrive a day ahead of your surgery and may need to stay for several days after. Ensure that you budget for accommodations, meals and parking.
• Costs for your support person — If someone is coming with you to help with your care before and after surgery, you need to account for their travel and accommodation costs as well.

Financial support available

There may be some financial help available depending on your employer and your income bracket. 

• Paid leave — Speak with your employer or Human Resources department about any short-term disability, sick time or vacation time you can use during your time off work for surgery. If you work for an employer that needs a formal request for time off, you can get a letter from your health provider or surgeon. The letter doesn’t need to specify the reasons that you’ll be away if you’d prefer not to share the nature of your surgery.
• Extended benefits — If you have extended benefits, check your program to see what is covered.
• Disability assistance — If you are on provincial disability assistance, you can contact the Ministry of Social Development and Poverty Reduction to discuss funding for travel and medically necessary Treatments, procedures or services that health care professionals determine are essential for diagnosing or treating a medical condition based on established medical guidelines and individual patient needs. supplies. Your primary care provider can write you a letter of support to access these funds.
• EI Sickness Benefit — The EI Sickness Benefit can be an option for individuals who are working and meet the eligibility criteria
• First Nations Health Authority (FNHA) Benefits Program — Individuals who are Indigenous, have status and live in B.C. are able to access FNHA benefits. These benefits can provide coverage for gender-affirming resources and postoperative supplies, like mesh underwear.
• Fundraising — Consider organizing online or in-person fundraisers.

There are also several programs that can help you cover transportation costs, including:

• Hope Air — A Canadian charity that arranges free flights for low-income Canadians who must fly to get health care.
• Travel Assistance Program (TAP) — If travel costs are a barrier for you, you may qualify for this program. You can apply for the program through your primary care provider. Visit the TAP website to learn about the application process.
• First Nations Health Authority Medical Transportation Benefit — FNHA benefits can also cover the costs of travel, accommodation and meals when you need to travel for medically necessary care. 

Prepare around the home

There are plenty of things you can do to prepare your home so things are easier for you when you return from surgery. Preparing ahead of time will make your life easier and will give you time to rest. A few simple things include:

• Washing your sheets ahead of time so you can come home to clean bedding and clothing
• Making sure your comfy, loose-fitting clothing is easy to find
• Collecting all of the medical supplies recommended your surgeon 
• Stocking up on non-perishable groceries 
• Preparing meals then freezing them

Arrange support

Important

You’ll need someone 18 years or older to escort you to your home or accommodations. You’ll also need someone to supervise you for 24 hours following surgery.

Recovery will be easier if you have support available to you in the weeks after surgery. 

Planning how to get to and from your surgical centre is important. You won’t be able to drive after your surgery so you’ll need someone 18 years or older to escort you to your home or accommodations. If you don’t have someone to bring you home from the hospital, you can use a service like Hospital Transfers.

You’ll also need someone to supervise you for 24 hours following surgery.

Aside from having someone drive you home, you’ll likely need help with:

• Meal preparation (rocery and meal delivery services are a good option if you don’t have someone to help you with this)
• Caring for children or pets
• Doing regular chores like taking out the garbage and recycling

Fortunately, lots of people like to help. It gives the helper a chance to feel good and show they care, especially if you ask for help with something specific. Download the Phalloplasty, Metoidioplasty, Erectile Tissue Release Workbook for a checklist for people who want to support you before and after surgery.