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What You Need to Know Before Genital Reconstruction Surgery

Living your life fully as your true self is extremely brave, and thankfully the medical process of transition is something that is receiving better insurance coverage. As a transgender or nonbinary person, if you choose to undergo genital reconstruction surgery (GRS), also called gender affirming surgery or gender reassignment surgery, as part of your transition, there are some things you should consider.

The Inside Scoop

Prior to the COVID-19 pandemic, I traveled to Canada to observe and learn from the entire team at GRS Montreal to continue to better understand the surgical portion of GRS. While there, I was able to observe multiple surgeries, such as: vaginoplasty (with and without a cavity), phalloplasty, metoidioplasty, insertion of penile implants, breast augmentation, mastectomy, Adam’s apple reduction, and facial feminization surgery, as well as pre and post-operative patient appointments. Additionally, I interacted, and spoke, with every member of the care team, from the nurses all the way up to the surgeons. This gave me an insider’s view into what happens during reconstruction surgery, as well as the viewpoints of the health care providers involved.

Things to Consider About Genital Reconstruction Surgery

Genital Reconstruction Surgery Is Complex and Lengthy

It does not make a difference if you are transitioning male to female or female to male (you may see the terms mtf or ftm to represent this), these surgeries are long, and they require a highly trained surgeon. And even with the best surgeons, there is always a chance that after a surgery in this area, you may experience some degree of pelvic floor dysfunction . Many of these surgeries can affect your pelvic floor muscles , and it is a good idea to talk to a pelvic floor physical therapist before you undergo a big procedure like this. At the GRS Montreal surgical center, vaginoplasty takes around 2 hours. Comparatively, a phalloplasty can take 8+ hours, and that is actually just the first stage. Due to the length and complexity of these procedures, take time to research your surgeon/surgery center. Here are some helpful questions you may want to ask your health care team/surgeon before you decide to have this surgery:

  • How long/how many surgeries of this exact type have they completed?
  • Where did they receive their training?
  • Do they engage in continuing education? (Dr. Brassard, the founder of GRS Montreal, teaches other surgeons how to do these surgeries, so you know he and his team are the very best.)

After Care After Your Procedure Is Very Important

GRS Montreal is SERIOUSLY a patient’s paradise! The surgery center has a hospital and a complete recovery house all under one roof. Patients transition from the surgical suite to their hospital room, and then they finally move to the recovery house all in one place. They have access to nurses 24/7 and can converse with the surgeons whenever they need. The bottom line is, not all patients in the world get this level of care after surgery, even for other surgical procedures. This time period after surgery is critical because this is when you learn how to interact in the world with your new genitalia. It is also important that you start or continue to do any pelvic floor physical therapy you’ve been given, as your pelvic health may be affected by these procedures. Here are some helpful questions to ask about recovering from these surgeries:

  • What are common post-surgical complications?
  • How are these post-surgical complications managed by your staff?
  • How do you support me during the time I am in your hospital/recovery center to ensure I succeed when I transition home?
  • How do I contact you once I am discharged and how long does it take to hear back from you?

Pelvic Floor Physical Therapy Should Be Part of Your Care

Dr. Brassard is a big supporter of pelvic floor physical therapy for these patients when needed. When deciding where to get your surgery and care, understanding the surgeon/surgical center’s treatment approach before, during and following your procedure will help you to plan, have better outcomes, and meet your personal goals for GRS. It is likely that a pelvic floor therapist will be part of your care team. Here are some helpful questions to ask about your care throughout the surgery process:

Your Journey Is Your Own

Use this article as a jumping-off point for your conversations as you embark upon the exciting journey of genital reconstruction surgery. While I understand that choosing the location of your surgery/surgical team may be limited based on your insurance provider , geographic location and many other factors, open dialogue and clear understanding are key for successful medical decisions. So Many Thanks

I am extremely grateful to GRS Montreal for allowing me the opportunity to shadow. It was truly a treat to have the opportunity to gain knowledge and share my knowledge as well. I can’t wait to share more details, and better support the journey each of you faces! Extra References

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