Consultation and preparation

Before your consultation

• Write down the goals you want to discuss. You do not need to choose a procedure first.
• Prepare a list of medications, supplements, allergies and previous operations.
• Bring relevant records or ask how to send them securely.
• Tell the team about practical constraints such as travel, work, caregiving or help at home.

Program requirements

Dr. Gupta confirmed the following for the adult genital-surgery pathway discussed in these materials:

• Age 19 or older.
• Two support letters from two different mental health professionals.
• 12 continuous months of hormone therapy.
• Three months nicotine-free before surgery and six months afterward. This includes nicotine patches, gum and lozenges.

These are program requirements, not a statement of universal legal, professional or insurance rules. Ask how they apply to your procedure and circumstances.

Insurance and documentation

• Ask your plan whether the procedure and clinicians are covered.
• Ask about prior authorization, letters, referrals and any time limits on documents.
• Request an estimate of your own costs and ask which services are billed separately.
• Keep copies of decisions and ask the team how to address missing information.

Coverage criteria and program requirements are different. The website does not determine benefits or guarantee payment. AuthIQ coverage exploration is planned for a later beta.

Instructions from your team

Hair-removal areas

For penile-inversion vaginoplasty, the shaded areas in the program’s existing hair-removal handout remain current. Complete hair removal at least six weeks before surgery.

For radial forearm phalloplasty and radial artery urethroplasty used in abdominal phalloplasty, the entire volar surface—the front or palm-facing side—of the forearm must be hair-free. Complete hair removal at least six weeks before the operation that uses the forearm tissue. Confirm your treatment plan with the team.

Hair removal is typically not required for robotic-assisted peritoneal vaginoplasty. No hair removal is required for zero-depth vulvoplasty in this practice.

Obtain a current preparation packet for your procedure. Confirm medication and supplement instructions, anesthesia preparation, skin preparation and any bowel preparation directly with the team.

Do not use an old handout or a generic checklist to decide when to stop a medication or begin fasting.

Medication and fasting instructions

Follow the individualized instructions from your anesthesia team for medication holds and when to stop eating or drinking. This includes instructions for GLP-1 medications. If your instructions are missing, unclear or differ between documents, contact the team to clarify before changing medications or fasting.

Travel and support

Questions for consultation

Select the questions you want to bring and add your own. Your list stays in this page and resets when you reload it.

Sources and review

Based on supplied University Hospitals program handouts and Daly Horton’s educational illustrations (2024), with Dr. Gupta’s October 2026 clarifications. The handouts describe particular techniques and pathways; they are not a substitute for your individual instructions.

University Hospitals gender-affirmation surgery service ↗