If you’re considering gender confirmation bottom surgery, also known  as genital reconstruction surgery or sex reassignment surgery, it’s crucial to have thorough discussions with your healthcare providers. Here are some important questions you may want to ask:

  1. What are the different surgical options available? There are different procedures available depending on whether you’re transitioning from male-to-female (MTF) or female-to-male (FTM). Understanding the procedures can help you make an informed decision.
  2. What are the risks and potential complications of each procedure? All surgeries carry risks, such as infection, bleeding, or reactions to anesthesia. There may also be risks specific to the procedure, like loss of sensation or need for revision surgeries.
  3. What results can I realistically expect? It’s important to have realistic expectations about the surgery. This includes understanding how your body will look and function after surgery, including sexual function.
  4. What is the recovery process like? Recovery can be a long process and may involve pain, swelling, and a period of sexual abstinence. You may also need to do regular post-operative care at home, like dilation for MTF surgery.
  5. What is the cost of the surgery and aftercare, and will my insurance cover it? The cost of the surgery can be high, and not all insurance companies cover it. It’s important to understand all the costs involved, including aftercare and potential future surgeries.
  6. What type of mental health support is available? Transitioning, including undergoing surgery, can be emotionally challenging. Mental health support is a crucial part of the process.
  7. How much experience do you have with this surgery, and can I speak to any previous patients about their experiences? You want to ensure your surgeon is experienced and can provide patient testimonials or before-and-after pictures.
  8. What are the requirements to qualify for surgery? Many surgeons and insurance companies follow the WPATH (World Professional Association for Transgender Health) Standards of Care, which require things like a period of real-life experience and letters of recommendation from mental health professionals.
  9. What kind of follow-up care is provided? Follow-up care is crucial after any surgery. Find out how often you’ll have appointments, how complications are handled, and who to contact with questions or concerns.

This is a significant decision that can greatly impact your life. Be sure you have all the information you need to make an informed decision.

Bottom surgery information

Bottom surgery, also known as genital reconstruction surgery, is a term used in the context of gender-affirming procedures for transgender individuals. It involves surgical interventions to alter the genital anatomy to align with an individual’s affirmed gender. The specific procedures can vary, and they are typically categorized into two main types for transgender men (assigned female at birth):

  1. Phalloplasty:
    • Description: Phalloplasty is a surgical procedure that involves constructing a neophallus (new penis) using various techniques. It may include the use of a graft, often taken from the forearm or thigh, to create the penile shaft. Additionally, procedures such as urethral lengthening, scrotoplasty, and erectile implants may be part of the process.
    • Considerations: Phalloplasty is a complex procedure with several stages. It offers the possibility of a functional neophallus, but the recovery can be lengthy.
  2. Metoidioplasty:
    • Description: Metoidioplasty involves releasing the clitoral ligaments to allow the clitoris to extend, resembling a small penis. Urethral lengthening and scrotoplasty are also potential components of metoidioplasty. Some individuals may opt for testicular implants to enhance the appearance of the genital area.
    • Considerations: Metoidioplasty is a less complex procedure compared to phalloplasty and may be associated with a shorter recovery period.
  3. Scrotoplasty:
    • Description: Scrotoplasty is a procedure focused on creating a scrotum, the pouch of skin and muscle that houses the testicles. This can be performed as part of both phalloplasty and metoidioplasty.
    • Considerations: Scrotoplasty enhances the visual masculinity of the genital area and can be combined with other procedures.
  4. Urethral Lengthening:
    • Description: Urethral lengthening involves extending the urethra to allow individuals to urinate through the neophallus. This procedure is often part of both phalloplasty and metoidioplasty.
    • Considerations: Urethral lengthening is crucial for functional outcomes and aligns the urinary system with the reconstructed genital anatomy.
  5. Vaginectomy:
    • Description: Vaginectomy is a procedure to close or remove the vaginal canal. It is often performed in combination with other bottom surgery procedures to create a more male-typical anatomy.
    • Considerations: Vaginectomy is a step toward aligning the physical anatomy with the affirmed gender.
  6. Glansplasty:
    • Description: Glansplasty involves shaping and refining the head of the neophallus to resemble the glans of a biological penis.
    • Considerations: Glansplasty contributes to the aesthetic appearance of the neophallus.
  7. Postoperative Care:
    • Description: Postoperative care is a crucial aspect of bottom surgery. It includes wound care, monitoring for complications, and following the surgeon’s recommendations for a smooth recovery.
    • Considerations: Postoperative care varies based on the specific procedures performed and may involve catheter management, dressing changes, and restrictions on physical activities.
  8. Complications and Risks:
    • Description: Understanding potential complications and risks associated with bottom surgery is essential for informed decision-making. Complications can include infection, poor wound healing, and sensory changes.
    • Considerations: Surgeons discuss potential risks during the preoperative consultation, and individuals should be aware of both short-term and long-term considerations.
  9. Recovery Time:
    • Description: Recovery time varies depending on the specific procedures performed. It involves a healing period during which individuals need to follow postoperative care instructions to ensure optimal outcomes.
    • Considerations: Surgeons provide guidelines on when individuals can resume normal activities and engage in sexual activity.
  • Genital Sensation:
    • Description: Genital sensation is an important consideration for individuals undergoing bottom surgery. Surgeons aim to preserve or enhance sensation in the genital area to improve the overall experience.
    • Considerations: The extent of preserved sensation can vary among individuals, and surgeons discuss expectations during the consultation process.

It’s important for individuals considering bottom surgery to consult with experienced gender-affirming surgeons, discuss their goals and expectations, and thoroughly understand the procedures involved, potential risks, and expected outcomes. The decision to undergo bottom surgery is highly personal, and individuals may benefit from support and guidance throughout the entire process, including preoperative preparation and postoperative care.

FTM genital surgery

FTM (Female-to-Male) genital surgery, also known as bottom surgery or phalloplasty/metoidioplasty, is a gender-affirming procedure designed to alter the genital anatomy to align with an individual’s affirmed male gender. The specific surgical techniques can vary, and the decision to undergo genital surgery is a highly personal one. Here are key details on FTM genital surgery:

1. Phalloplasty:

  • Description: Phalloplasty is a surgical procedure that involves constructing a neophallus (new penis). The phalloplasty process may include using tissue grafts, often from the forearm or thigh, to create the penile shaft. Additional procedures such as urethral lengthening, scrotoplasty (scrotum creation), and erectile implants may be part of the overall phalloplasty process.
  • Considerations: Phalloplasty is a complex and multi-staged procedure that offers the possibility of a functional neophallus. However, it typically involves a longer recovery period.

2. Metoidioplasty:

  • Description: Metoidioplasty involves releasing the clitoral ligaments to allow the clitoris to extend, resembling a small penis. Urethral lengthening and scrotoplasty are also potential components of metoidioplasty.
  • Considerations: Metoidioplasty is a less complex procedure compared to phalloplasty and may be associated with a shorter recovery period.

3. Scrotoplasty:

  • Description: Scrotoplasty is a procedure focused on creating a scrotum, the pouch of skin and muscle that houses the testicles. This can be performed as part of both phalloplasty and metoidioplasty.
  • Considerations: Scrotoplasty enhances the visual masculinity of the genital area and can be combined with other procedures.

4. Urethral Lengthening:

  • Description: Urethral lengthening involves extending the urethra to allow individuals to urinate through the neophallus. This procedure is often part of both phalloplasty and metoidioplasty.
  • Considerations: Urethral lengthening is crucial for functional outcomes and aligns the urinary system with the reconstructed genital anatomy.

5. Vaginectomy:

  • Description: Vaginectomy is a procedure to close or remove the vaginal canal. It is often performed in combination with other bottom surgery procedures to create a more male-typical anatomy.
  • Considerations: Vaginectomy is a step toward aligning the physical anatomy with the affirmed male gender.

6. Glansplasty:

  • Description: Glansplasty involves shaping and refining the head of the neophallus to resemble the glans of a biological penis.
  • Considerations: Glansplasty contributes to the aesthetic appearance of the neophallus.

7. Postoperative Care:

  • Description: Postoperative care is a crucial aspect of FTM genital surgery. It includes wound care, monitoring for complications, and following the surgeon’s recommendations for a smooth recovery.
  • Considerations: Postoperative care varies based on the specific procedures performed and may involve catheter management, dressing changes, and restrictions on physical activities.

8. Complications and Risks:

  • Description: Understanding potential complications and risks associated with FTM genital surgery is essential for informed decision-making. Complications can include infection, poor wound healing, and sensory changes.
  • Considerations: Surgeons discuss potential risks during the preoperative consultation, and individuals should be aware of both short-term and long-term considerations.

9. Recovery Time:

  • Description: Recovery time varies depending on the specific procedures performed. It involves a healing period during which individuals need to follow postoperative care instructions to ensure optimal outcomes.
  • Considerations: Surgeons provide guidelines on when individuals can resume normal activities and engage in sexual activity.

 

Transgender phalloplasty

Transgender phalloplasty is a gender-affirming surgical procedure designed to create a neophallus (new penis) for transgender men or individuals assigned female at birth. This complex surgical procedure aims to provide a more masculine appearance and may include additional components such as urethral lengthening, scrotoplasty, and the implantation of erectile devices. Here are details on transgender phalloplasty:

Procedure Overview:

  1. Graft Selection:
    • Surgeons often use autologous tissue grafts, commonly from the forearm (anterolateral thigh and radial forearm) or thigh. The graft provides the material for constructing the penile shaft.
  2. Neophallus Construction:
    • The graft is meticulously shaped to form the neophallus. The surgeon carefully structures the phallus, considering proportions and aesthetics.
  3. Urethral Lengthening:
    • Urethral lengthening is a crucial aspect, allowing individuals to urinate through the neophallus. The surgeon reroutes the urethra to extend to the tip of the neophallus.
  4. Glansplasty:
    • The head of the neophallus (glans) is sculpted to resemble the natural glans of a penis. This enhances the overall aesthetic appearance.
  5. Scrotoplasty:
    • Scrotoplasty involves the creation of a scrotum, which houses testicular implants. The scrotum contributes to a more authentic male appearance.
  6. Implantation of Erectile Devices:
    • To achieve erectile function, surgeons may implant inflatable or malleable penile prostheses. These devices allow for the simulation of erections.

Considerations:

  1. Complexity and Staging:
    • Phalloplasty is a complex and staged procedure often requiring multiple surgeries. Staging allows for proper healing and optimization of outcomes.
  2. Recovery Time:
    • The recovery period for phalloplasty is significant, and individuals should follow postoperative care instructions diligently. It may take several months to resume normal activities.
  3. Complications and Risks:
    • Like any surgical procedure, phalloplasty comes with potential risks, including infection, poor wound healing, and sensory changes. Surgeons discuss these risks during the preoperative consultation.
  4. Genital Sensation:
    • Preserving or enhancing genital sensation is a priority. However, the extent of sensory outcomes can vary among individuals.
  5. Postoperative Care:
    • Postoperative care involves managing wounds, attending follow-up appointments, and adhering to restrictions on activities. Catheter management is often part of the initial recovery.
  6. Aesthetic Outcomes:
    • Achieving realistic and aesthetically pleasing outcomes is a primary goal. Surgeons work closely with patients to understand their desired results.

Emotional and Psychological Considerations:

  1. Preoperative Counseling:
    • Comprehensive preoperative counseling is essential to ensure individuals are well-informed about the procedure, potential outcomes, and the impact on their lives.
  2. Postoperative Support:
    • Supportive care, including mental health support, is crucial during the recovery process. Individuals may experience a range of emotions, and having a support system is beneficial.
  3. Realistic Expectations:
    • Setting realistic expectations regarding outcomes, including potential limitations, is vital for postoperative satisfaction.

Follow-Up:

  1. Long-Term Follow-Up:
    • Long-term follow-up appointments are essential to monitor healing, address concerns, and evaluate the overall success of the procedure.
  2. Possible Revisions:
    • In some cases, individuals may opt for additional procedures or revisions to further refine the results.

Transgender phalloplasty is a complex and transformative surgical procedure that can significantly impact the lives of transgender men. Open communication with experienced gender-affirming surgeons, thorough preoperative counseling, and postoperative support contribute to a positive surgical experience and outcomes. Individuals considering phalloplasty should carefully weigh the benefits, risks, and emotional aspects before deciding to undergo the procedure.

 

Metoidioplasty details

Metoidioplasty is a gender-affirming surgical procedure designed to create a neophallus (new penis) for transgender men or individuals assigned female at birth. Unlike phalloplasty, which involves using tissue grafts to construct a larger neophallus, metoidioplasty focuses on utilizing the clitoral tissue that has been hormonally enlarged through testosterone therapy. The procedure aims to enhance the visual appearance of the genitalia, and it may also include additional components such as urethral lengthening, scrotoplasty, and vaginectomy. Here are details on metoidioplasty:

Procedure Overview:

  1. Clitoral Release:
    • The first step in metoidioplasty involves releasing the clitoral ligaments. Testosterone therapy typically enlarges the clitoris, and the release allows it to extend to a more prominent position.
  1. Urethral Lengthening:
    • Urethral lengthening is often performed during metoidioplasty to allow individuals to urinate through the neophallus. The surgeon reroutes the urethra to extend to the tip of the clitoris, creating a more natural appearance.
  1. Scrotoplasty:
    • Scrotoplasty may be part of metoidioplasty, involving the creation of a scrotum. The scrotum houses testicular implants, contributing to a more masculine appearance.
  1. Vaginectomy:
    • Vaginectomy, the closure or removal of the vaginal canal, is sometimes performed in conjunction with metoidioplasty to align the physical anatomy with the affirmed male gender.

Considerations:

  1. Less Complexity:
    • Metoidioplasty is generally considered less complex than phalloplasty. It may be a suitable option for individuals who prefer a less extensive surgical procedure.
  1. Shorter Recovery Period:
    • Compared to phalloplasty, metoidioplasty often involves a shorter recovery period. However, individual experiences can vary.
  1. Sensory Outcomes:
    • Sensation in the neophallus can be a positive aspect of metoidioplasty. Preserving or enhancing genital sensation is a priority.
  1. Genital Appearance:
    • Metoidioplasty aims to create a neophallus that aligns with a more masculine appearance. The surgeon works closely with the individual to understand their desired outcomes.
  1. Complications and Risks:
    • While metoidioplasty is generally considered less complex, it is not without potential risks, including infection, poor wound healing, and sensory changes. Surgeons discuss these risks during preoperative consultations.
  1. Postoperative Care:
    • Postoperative care involves managing wounds, attending follow-up appointments, and adhering to restrictions on activities. Catheter management may be part of the initial recovery.

Emotional and Psychological Considerations:

  1. Preoperative Counseling:
    • Comprehensive preoperative counseling is crucial to ensure individuals have a clear understanding of the procedure, potential outcomes, and the impact on their lives.
  1. Postoperative Support:
    • Supportive care, including mental health support, is important during the recovery process. Individuals may experience a range of emotions, and having a support system is beneficial.
  1. Realistic Expectations:
    • Setting realistic expectations regarding outcomes, including potential limitations, is vital for postoperative satisfaction.

Follow-Up:

  1. Long-Term Follow-Up:
    • Long-term follow-up appointments are essential to monitor healing, address concerns, and evaluate the overall success of the procedure.
  1. Possible Revisions:
    • In some cases, individuals may opt for additional procedures or revisions to further refine the results.

Metoidioplasty is a surgical option that offers a more streamlined approach for individuals seeking genital gender affirmation. Open communication with experienced gender-affirming surgeons, thorough preoperative counseling, and postoperative support contribute to a positive surgical experience and outcomes. Individuals considering metoidioplasty should carefully weigh the benefits, risks, and emotional aspects before deciding to undergo the procedure.

 

Gender confirmation surgery queries

Gender confirmation surgery, also known as gender-affirming surgery or sex reassignment surgery, is a set of procedures that transgender individuals may undergo to align their physical characteristics with their gender identity. Below are common queries related to gender confirmation surgery along with corresponding details:

1. What is Gender Confirmation Surgery?

  • Details: Gender confirmation surgery encompasses various procedures designed to change the physical features of an individual’s body to be more congruent with their gender identity. These procedures may include chest/breast surgeries, genital surgeries, and other related surgeries.

2. What are the Different Types of Gender Confirmation Surgeries?

  • Details: The types of gender confirmation surgeries depend on an individual’s gender identity. For transgender women (assigned male at birth), surgeries may include orchiectomy, vaginoplasty, and facial feminization surgery. For transgender men (assigned female at birth), surgeries may include mastectomy, metoidioplasty, and phalloplasty.

3. Who is a Candidate for Gender Confirmation Surgery?

  • Details: Candidates for gender confirmation surgery are typically individuals who have undergone psychological assessments, hormone therapy, and have lived in their affirmed gender for a specified duration. Eligibility criteria may vary among healthcare providers.

4. What is the Role of Hormone Therapy Before Surgery?

  • Details: Hormone therapy is often a prerequisite for gender confirmation surgery. It helps induce physical changes, such as breast development or facial hair growth, depending on the desired gender.

5. How Long Does Recovery Take After Gender Confirmation Surgery?

  • Details: Recovery times vary depending on the type of surgery. For example, chest surgery recovery may be shorter than genital surgeries. Generally, individuals can expect a few weeks to several months for a full recovery.

6. What Are the Risks and Complications Associated with Gender Confirmation Surgery?

  • Details: Common risks include infection, bleeding, scarring, and changes in sensation. Specific risks vary based on the type of surgery. Surgeons discuss potential complications during preoperative consultations.

7. Does Insurance Cover Gender Confirmation Surgery?

  • Details: Insurance coverage for gender confirmation surgery varies by region, insurance provider, and policy. Increasingly, more insurance plans are covering these procedures. Individuals should check with their specific insurance provider for details.

8. Can Gender Confirmation Surgery Be Reversed?

  • Details: Some procedures, like mastectomy or vaginoplasty, are generally considered irreversible. However, detransition options may vary based on the specific surgeries and individual circumstances.

9. How Does Gender Confirmation Surgery Impact Fertility?

  • Details: Some surgeries, such as hysterectomy or orchiectomy, may impact fertility. Individuals interested in preserving fertility should discuss options with their healthcare providers before surgery.

10. What Support is Available for Postoperative Care and Mental Health?

  • Details: Postoperative care often involves counseling or mental health support. Many transgender support groups and organizations provide resources to help individuals navigate the emotional aspects of gender confirmation surgery.

11. Are There Age Requirements for Gender Confirmation Surgery?

  • Details: Age requirements vary by location and surgical procedures. In some cases, individuals may need to be of legal age to provide informed consent. Some procedures, particularly genital surgeries, may have age-related guidelines.

12. Can Non-Binary Individuals Undergo Gender Confirmation Surgery?

  • Details: Gender confirmation surgery is not exclusive to binary gender identities. Non-binary individuals may seek surgeries that align with their gender identity, such as chest surgery or specific genital procedures.

13. What Are the Alternatives to Surgical Transitioning?

  • Details: Alternatives to surgical transitioning include hormone therapy, social transitioning, and non-surgical procedures (e.g., voice training, facial hair removal). Each individual’s journey is unique, and not all transgender individuals pursue surgical options.

14. How Can I Find a Qualified Surgeon for Gender Confirmation Surgery?

  • Details: Finding a qualified surgeon involves researching experienced gender-affirming surgeons, reading reviews, and consulting with healthcare providers. Many surgeons specialize in gender confirmation surgery.

These queries address common concerns and considerations related to gender confirmation surgery. It’s crucial for individuals considering these procedures to consult with knowledgeable healthcare professionals to make informed decisions based on their unique circumstances and goals.

 

Surgical options for transgender men

Surgical options for transgender men, often referred to as Female-to-Male (FTM) transgender individuals, are diverse and can involve various procedures to align physical characteristics with their affirmed gender. The choice of surgeries depends on individual preferences, goals, and medical considerations. Here are some common surgical options for transgender men:

1. Mastectomy (Chest Surgery):

  • Description: Also known as “top surgery,” mastectomy is a procedure to remove breast tissue and create a more masculine chest contour.
  • Considerations: This surgery is often a significant step for transgender men and can enhance their overall sense of gender identity.

2. Hysterectomy:

  • Description: Hysterectomy involves the removal of the uterus. Some transgender men opt for this surgery to align their physical anatomy with their gender identity.
  • Considerations: Hysterectomy may be performed alone or as part of a more comprehensive gender confirmation surgery.

3. Oophorectomy:

  • Description: Oophorectomy is the removal of the ovaries. Transgender men who have not undergone hysterectomy may choose oophorectomy to stop estrogen production.
  • Considerations: Oophorectomy can be a standalone procedure or part of gender confirmation surgeries.

4. Metoidioplasty:

  • Description: Metoidioplasty involves releasing the clitoral ligaments to allow the hormonally enlarged clitoris to extend. Urethral lengthening and scrotoplasty are potential components.
  • Considerations: It is a less complex procedure compared to phalloplasty, and some individuals prefer it due to the shorter recovery period.

5. Phalloplasty:

  • Description: Phalloplasty is a complex procedure to create a neophallus using tissue grafts, often from the forearm or thigh. It may include urethral lengthening and scrotoplasty.
  • Considerations: Phalloplasty offers the possibility of a functional neophallus but involves multiple stages and a more extended recovery.

6. Urethral Lengthening:

  • Description: Urethral lengthening is a component of both metoidioplasty and phalloplasty. It allows individuals to urinate through the neophallus.
  • Considerations: Preserving urinary function is an important aspect of gender-affirming genital surgeries.

7. Scrotoplasty:

  • Description: Scrotoplasty involves the creation of a scrotum, often housing testicular implants to enhance the masculine appearance of the genital area.
  • Considerations: Scrotoplasty can be performed as part of metoidioplasty or phalloplasty.

8. Vaginectomy:

  • Description: Vaginectomy is a procedure to close or remove the vaginal canal. It is often performed in conjunction with other genital surgeries.
  • Considerations: Vaginectomy is a step toward aligning the physical anatomy with the affirmed male gender.

9. Facial Masculinization Surgery (FMS):

  • Description: FMS includes various procedures to create a more masculine facial appearance. This may involve jaw contouring, rhinoplasty, and other facial surgeries.
  • Considerations: FMS can contribute to a more gender-affirming facial aesthetic.

Surgical options for transgender men are highly individual, and the decision to pursue specific procedures depends on personal preferences, goals, and overall health. Consulting with experienced gender-affirming surgeons and receiving comprehensive preoperative counseling are crucial steps in the decision-making process.

 

Genital surgery consultation questions

When considering genital surgery as part of gender confirmation surgery, individuals often have consultations with experienced gender-affirming surgeons to discuss the procedures, potential outcomes, and other important aspects. Here are some key questions that individuals may consider asking during a genital surgery consultation:

1. Qualifications and Experience:

  • a. How many gender confirmation surgeries have you performed?
  • b. Can you provide before-and-after photos of previous patients’ results?
  • c. What are your qualifications and board certifications?

2. Surgical Options:

  • a. What surgical options are available for genital surgery?
  • b. Can you explain the differences between metoidioplasty and phalloplasty?
  • c. What factors should I consider when choosing between the available procedures?

3. Expectations and Realistic Outcomes:

  • a. What realistic outcomes can I expect from the chosen procedure?
  • b. Are there limitations to the results, and what factors may influence them?
  • c. Can you describe the anticipated aesthetic and functional results?

4. Recovery Process:

  • a. What is the typical recovery process for the chosen procedure?
  • b. How long will it take before I can resume normal activities, including work and exercise?
  • c. What postoperative care will be required, and what are the potential complications?

5. Sensation and Sexual Function:

  • a. How is genital sensation typically affected by the chosen procedure?
  • b. What impact might the surgery have on sexual function and satisfaction?
  • c. Are there options for postoperative interventions to enhance sensation or function?

6. Scarring and Aesthetics:

  • a. Where will the incisions be made, and what can I expect in terms of scarring?
  • b. Can you discuss the aesthetic aspects of the surgery, including the appearance of the neophallus or reconstructed genitalia?
  • c. Are there options for scar revision or additional procedures for refinement?

7. Follow-Up Care and Long-Term Support:

  • a. What does the follow-up care plan look like after surgery?
  • b. How often will follow-up appointments be scheduled, and what will be assessed during these visits?
  • c. Are there long-term support services available, such as counseling or additional interventions if needed?

8. Insurance and Financial Considerations:

  • a. Does insurance typically cover the chosen genital surgery?
  • b. What are the anticipated costs, including surgeon fees, facility fees, and anesthesia costs?
  • c. Are there financing options or assistance programs available?

9. Preoperative Requirements:

  • a. What are the prerequisites for undergoing genital surgery?
  • b. Do I need to undergo hormone therapy before surgery, and if so, for how long?
  • c. Are there any age or health-related requirements for the chosen procedure?

These questions can serve as a starting point for discussions during genital surgery consultations. However, it’s important for individuals to tailor their questions based on their specific concerns, goals, and expectations. Open and transparent communication with the surgeon is crucial in making informed decisions about gender confirmation surgery.