GCS is usually performed as the last gender transition procedure, and patients must meet several requirements set out by the World Professional Association for Transgender Health (WPATH) in order to be eligible for this surgery.  These requirements include two letters of recommendation (one from your mental health clinician and one from the physician who provides your hormone therapy), at least one year of continuous hormone therapy, and at least one year of living full-time as a woman.  Following the WPATH guidelines will help to ensure that you feel satisfied with the results of your GCS and with your decision to undergo the surgery.

GCS is considered a major surgery, and it is essential that patients follow all pre-procedure instructions in order to obtain the very best surgical outcome.  It is important that the ICTC staff have all your pertinent medical information prior to scheduling any surgery.  Your pre-operative appointment will be scheduled one week to two days before the GCS, and you’ll also need to start a bowel prep two days in advance, followed by a clear liquid diet (e.g., clear broth, coffee, tea, water, soda).  Do not consume anything during this time period that is red, orange, purple, or caramel in color.  Hormones and other drugs may need to be discontinued temporarily.  On the day of your surgery, you’ll arrive at ICTC in the morning and meet with your anesthesiologist and surgeon.  Make sure that you leave cash and any other valuables at home.

The average recovery period for GCS ranges from 4-6 weeks.  We do require one overnight with an RN following the procedure, and we also recommend making arrangements to stay close to ICTC for the first week or so, as you’ll need to visit your surgeon frequently.  Our staff can assist you in booking a hotel near-by with special medical rates.  We also suggest packing personal care and comfort items (e.g., a robe and slippers, throat drops, lotion and other toiletries), and a laptop or books to pass the time in the coming days.  During the initial recovery period, focus on resting, drinking plenty of water, and making sure that your surgical site is well-iced in order to prevent swelling.

It is normal for transwomen to have concerns about sexuality and sexual functioning following GCS.  For the majority of patients, sexual outcomes are very good.  Additionally, many post-GCS transwomen report an increased capacity for sexual intimacy related to greater comfort and satisfaction with their bodies.  Sexual activity can typically be resumed 8 weeks post-surgery, and after vaginal dilation has been completed.  However, it is important to note that GCS does carry a potential long-term risk for decreased sexual sensation.  Please do not hesitate to discuss any concerns you may have about post-surgical sexual functioning with your surgeon.

At ICTC, we know that each patient has her own unique needs and expectations, which is why we take an individualized, patient-centered approach to gender transition services.   During the preoperative consultation, your surgeon will take the time to discuss and understand your goals for GCS.  He will also perform a physical exam of the genitalia, which will help to determine the best GCS procedure for your unique anatomy.  Additionally, he’ll thoroughly explain the procedure and answer any questions you might have.