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Surgery and Health Status: Am I Eligible for Gender-Affirming Surgery?

An ideal candidate for surgery is someone who is both physically and emotionally healthy. Our surgeons will be able to determine your eligibility following a free, virtual consultation and a discussion of your medical history.

During your consultation, it is important to provide your surgeon with details on your current health, including any current prescriptions, over-the-counter medications, or supplements you may be taking. Certain medications may interfere with blood clotting or other medications used during surgery. Your surgeon  will let you know if any of your current medications must be discontinued prior to surgery.

Our surgeons evaluate  patients on a case-by-case basis. If you have significant health issues, such as diabetes, high blood pressure, or bleeding disorders, your surgeon will request medical clearance for surgery from your regular physician.

Age: Older Adult Patients

Prior to any surgery, you will need to undergo a physical examination with our surgeon or your local primary care provider. This will be accompanied by an in-depth discussion of your health history and cosmetic goals with your surgeon during the consultation phase. Generally speaking, a patient’s chronological age has a much lesser weight on their eligibility for surgery and the possible aesthetic outcomes. Factors like skin elasticity and a patient’s general health are far more important in determining eligibility and what kind of accommodations will be necessary to help a patient reach their surgical goals.

In the informational video below, Dr. Facque (he/him) talks about the GCC’s holistic approach to determining surgical eligibility to not arbitrarily discriminate against patients for their age or BMI:

BMI: Underweight and Plus-Sized Patients

Our surgeons do  not use the Body Mass Index (BMI) as a way to preclude people from having surgery. Losing or gaining a significant amount of weight following surgery can impact your final outcome, so it is important to discuss any long-term body composition goals or changes with your surgeon during your consultation. You can read more about our eligibility requirements around BMI here.

Please note that while the GCC does not impose BMI cutoffs for top surgery and facial surgery patients who have gone through a thorough medical clearance process, there still exist limits that may be imposed by the hospital anesthesia departments. Patients with a BMI >60 may not receive approval to proceed with surgery based on safety concerns and functional limitations that may make it difficult to properly ventilate–i.e., provide adequate air to the lungs–during surgery. Our surgeons and medical team can work with you to explain the process and determine how best to proceed.

In the informational video below, Dr. Jacobs (he/him) describes how our practice plans around the risks associated with undergoing surgery with a BMI over 30 without denying our patients access to gender-affirming care.

Smoking

You will have to stop smoking anything at all prior to your procedure. Cigarette smoking inhibits blood flow, which can delay the healing process and increase your risk of complications. Ideally you should stop smoking at least six weeks in advance of surgery, but you must stop smoking for, at minimum, at least a full three weeks prior to surgery and for three weeks after. Even a single cigarette during this period can negatively impact your healing – especially if your surgery includes nipple grafting. Nipple grafts are very sensitive to smoking and may not survive if you smoke at all.

High-Risk Medical Conditions

To reduce your risk of complications and negative side effects, it’s essential that you disclose all of your medical history to your surgeon during your consultation. Hiding significant health problems (or current prescriptions) because you think they will prevent you from having the procedure will only hurt you in the long run. Our practice is committed to accommodating a patient’s unique medical needs to ensure they can access quality, gender affirming surgical care.

Though the following medical conditions will not necessarily prevent you from being a good candidate for surgery, they may necessitate medical clearance from your regular physician:

• Heavy smoker or drinker
• Diabetes
• High blood pressure
• A bleeding disorder
• Lung or heart disease
• Obesity
• A previous stroke

In the following informational video, Dr. Facque answers the question: how does a previous stroke affect someone’s eligibility for top surgery?

In the clip below, Dr. Facque (he/him) talks about how having diabetes might affect someone’s eligibility for top surgery: