Patients must adhere to a strict no smoking and no nicotine consumption for 3 weeks before and after surgery to reduce nipple graft reduction, anesthesia interference and delayed wound healing. While nicotine is the major culprit, smoking marijuana can interfere with healing and anesthetic. We suggest that patients switch to edibles or CBD and communicate openly with their surgeon to minimize risk. We also advise patients to not drink alcohol one week before and after surgery, and to never drink while taking prescription pain medication.

At GCC, we use the labia minora tissue to create the phallus in metoidioplasty and phalloplasty. As a result, it is not possible to retain the vaginal opening. There are procedures that do not use the labia minora to create a phallus and preserve the vaginal opening, though these are not performed at GCC.

Patients who undergo breast reduction may be able to chestfeed, but may have to supplement with formula. There are some anecdotal cases of patients being able to chestfeed after undergoing aggressive breast reduction and buttonhole/inverted T, but for most forms of chest reconstruction this is not possible. For those who receive nipple grafts, the nipples are not connected to milk ducts. Chestfeeding for transfeminine individuals has been anecdotally reported. Patients who undergo breast augmentation can produce milk, but may need to be supplied. If breast/chestfeeding is a priority for you, you can speak with one of our board-certified surgeons in a free consultation.

We recommend that patients look for surgeons who specialize in serving non-binary patients. Look for surgeons who have a proven track record of not only performing gender-affirming procedures successfully, but also competency with non-binary patients. It is also valuable to seek recommendations from support groups, online communities, or individuals who have undergone similar surgeries.

The GCC’s insurance advocacy team has a 90% success rate in securing insurance coverage for interested patients. That said, insurance coverage for non-binary surgeries varies significantly depending on your specific insurance provider, plan and ability to provide necessary supporting documents. It is essential to reach out to your insurance company to understand their policies, requirements and limitations on gender-affirming surgery.