Tips for FTMs to Prepare for Gender Transition Surgery

Here are my top tips to prepare for FTM gender transition surgery!

Based on my own experiences, I have compiled a list of key tips to prepare for gender transition surgery (whether it is top surgery, bottom surgery, hysterectomy, or any other kind of surgery). The successful outcome of any surgeries you have in your gender transition journey will depend on many factors that are outside your control. However, what you can do is prepare for gender transition surgery thoroughly, and be ready with everything you need for a good recovery.

Medical ways to prepare for FTM gender transition surgery

Knowledge

Learn as much as you can about your surgery and meet with the medical team. Talk to your surgeon and your anesthesiologist, if possible. Ask them questions about everything, from risks to expected healing time. Ask them about negative signs to watch out for. The more knowledge you have, the better you will be able to manage your own recovery. Remember that no matter how many medical people are involved, at the end of the day no one is more powerful than you when it comes to your own health.

Be prepared

Knowing what to expect will make the experience easier to endure. For example, I was not prepared for the horrible experience of having my chest marked up immediately before top surgery. It is of course a necessary part of getting ready for breast removal. And really, it was worth it!

Honesty

When talking to your medical team, be 100% honest with them about everything – for example, any health issues you may have, including heart or lung disease, diabetes, high blood pressure, dental work, arthritis, excessive alcohol consumption, recreational drug use, smoking, or drug allergies.

I personally had a very slight heart condition, which I disclosed. I was worried it would prevent me having surgery. In fact, it just led to extra due diligence in checking that I was fit for surgery. I had to have a very thorough check from my cardiologist, and get a letter from him. As it turned out, I was in much better shape than I had realized.

Medications

Give your surgeon a list of all the medications you take, including supplements and homeopathic medications, so he/she can check that there are no potential dangers. Some surgeons will request that you stop taking all supplements a couple of weeks before surgery. For example, ginkgo biloba, ginseng, garlic, echinacea, fish oils, and vitamins may be risky to take before surgery. They may increase the chance of heart problems or bleeding. Some may affect how long anesthesia lasts, or interact badly with other medications, causing unexpected side effects.

Avoid over the counter meds

In general, try to avoid all over the counter medications in the weeks and days prior to surgery. During your surgery you will have all kinds of drugs put into your body, and you don’t want an unexpected interaction.

Surgical instructions before FTM surgery

Read all the instructions you get from your surgeon, memorize them, and follow them religiously. But don’t be afraid to question and figure things out. For example, my cardiologist told me NOT to stop taking my daily dose of baby Aspirin, but my surgeon told me that I absolutely HAD to stop. I ended up following the surgeon’s advice – after all, he was the one who was going to be cutting me open and dealing with the bleeding.

Be careful with Aspirin

If you are not on a daily dose of Aspirin, don’t take a dose for a headache the day before your surgery!

If you are on a daily dose of baby Aspirin, talk to your doctor and surgeon about quitting well before surgery. Aspirin thins the blood and therefore increases bleeding, which can lead to complications during and after surgery. Personally I was stuck in the operating room for an extra hour while they got a bleed under control, and then I was kept in the recovery room for an extra three hours because I kept fainting from loss of blood every time I stood up.

In the meantime, our car was towed from the “10 minutes pick up patients” parking zone! It was NOT fun. Also, all the internal bleeding left me with massive bruising on my right side. This meant I had to keep the drainage tubes in for a couple of weeks longer on that side. It also looked awful and made me really nervous.

In the end, the blood all just drained out, and I was fine.

Blood

Find out whether you may need to be given blood and if so, if you can lay in a supply of your own donated blood.

Blood donors

If you are a regular blood donor, do NOT donate for at least two months prior to your surgery. You are going to need all of your blood yourself. (You also cannot donate blood for a long time after surgery – the medical advisers at your blood donation center can be accessed by phone for advice on this.)

Blood pressure

Make sure your blood pressure is in good shape. If you are taking a medication for it, ask your surgeon and doctor if you should take it on the day of surgery.

Weight

Trans guys often seem to be under pressure to lose weight before surgery. While this is desirable, it is not always possible. Also, you should not be dieting in the month before surgery – you do not want to go into surgery under-nourished and weakened.

Supplies to lay in to prepare for gender transition surgery

Entertainment after surgery

Have some CDs or books lined up to try to stave off depression from the forced inactivity after the surgery. Try to make a collection of your favorite “feel-good” movies, to cheer yourself up. Make sure your remote controls and other devices are handy and accessible BEFORE you go in for your surgery.

Soap

Have a supply of antibacterial hand soap available and accessible – you will need to be very clean while you are healing, especially if you have drainage tubes that need daily cleaning.

Appropriate clothes for healing after FTM surgery

Have a supply of loose-fitting clothes ready. If you are having top surgery, make sure you will not have to pull your clothing over your head – you will be very restricted in how much you should raise your arms. So t-shirts will not work – you must have button-down shirts available.

Groceries

Lay in several weeks worth of groceries so you won’t have to go shopping, because that is way too strenuous.

Freeze-dried meals

I strongly suggest laying in a supply of high-quality freeze-dried meals, so that you can have a varied and nutritious diet without actually having to cook.

Fresh fruits and veggies

Your groceries should include lots of high quality health food, as your body needs this to heal itself and recover back to full strength. If you have someone who can bring your daily fresh fruits and vegetables, this is the best thing you can do for your recovery.

Vitamin supplements

I highly recommend Vitamin C and a multivitamin. The benefits of Vitamin C for healing are fairly well proven, and the multivitamin could be useful if your appetite is down for a while (mine always is after surgery). So make sure you have both of these in an easily accessible place before surgery. Personally, I started taking them both before surgery, to build up my reserves. But do check in with your surgeon or doctor about any supplements you are taking.

Things to QUIT as you prepare for gender transition surgery

Drinking: If you are a drinker, then quit drinking at least two weeks before surgery. This gives your body a chance to get back to peak physical condition. You don’t want to go into surgery with a liver and kidneys that are already over-stressed. Also, drinking can cause unexpected problems with anesthesia and bleeding.

Smoking: If you are a smoker, the best thing you can do it just quit completely, obviously. If you find you just cannot do that, then at least cut down as much as you possibly can prior to surgery. Smokers are more likely to have life-threatening blood clots during surgery. They are more likely to have post-surgical infections. And it is absolutely solidly proven that smokers heal more slowly than non-smokers. Of course they do – smoking impairs the ability to absorb the oxygen needed for every bodily function. I know from personal experience how incredibly hard it is to quit smoking – perhaps the thought of attaining your new body may be the push you need to achieve it this time?

Supplements and Medications to take before your gender transition surgery

Traumeel for healing

I strongly believe in the benefits of taking Traumeel, a naturopathic remedy that is said to help the body heal. However, there is no scientific proof that it really works. If you do take it, you should start a course well before surgery, to build up your reserves.

Stool softeners for after your surgery

Start taking stool softeners the day before surgery, and take them for a few days afterwards until you have your first bowel movement. After that, you can stop the stool softeners, but do continue to eat plenty of fruits and vegetables and supplement with a good fiber such as ground flax seed. Your surgeon might write you a prescription for stool softeners. If not, it is easy enough to buy them over the counter.

Human supports to organize as you prepare for gender transition surgery

First 24 hours after gender transition surgery

Make sure you have an adult who will spend at least the first 24 hours after surgery with you, in case of complications. I once did this for a stranger who had top surgery, as he had no one at all in the city who could do it for him.

Support system after surgery

Try to set up the best possible support system you can (family, friends, and a nursing service on standby if you can afford it). No one should have to recover from surgery without the support of other people. I was fortunate enough to have family and friends, including a very supportive wife.

Home nursing services after FTM surgery

As I was very anxious about surgery, I signed up with a home nursing service. Basically they came and met me, signed me up (for free), and told me I could call them out at any time, day or night, for $45 per visit. It gave me tremendous peace of mind to know they were out there. It’s often impossible to reach a doctor or surgeon on the phone, so having a nurse to talk to can feel like a lifesaver. I ended up calling the nursing service in on two occasions.

Both times they just reassured me, checked my dressings and vitals, and assured me that in fact I was not dying and did not have to go to emergency or page my surgeon. So basically I paid them to deal with my anxiety issues, and it was well worth it. I was also fortunate that my extended benefits covered this service, as long as my doctor gave me a note saying I needed it. If you will be largely on your own during recovery, finding a service like this could be really helpful and reassuring. And if you do have post-surgical complications, this could be invaluable.

Online transgender surgery support groups for FTMs

Another big support for me in my recovery was being in touch with online transgender surgery support groups. On a few occasions I was able to send out messages about my post-surgery anxieties, and was helped a lot by the informative and supportive messages I got back. Join one of these groups before, so you don’t have to go through any joining stress after surgery, when you are less strong.

These groups are usually closed groups, so you cannot just join instantly – you need to be approved, and that can take time, as they are all volunteer driven.

Good luck with your gender transition surgery! I hope it makes you as happy as mine has made me.

The above post is excerpted from my book, How I Changed my Gender from Female to Male. You can look inside this book and see the table of contents by clicking on the Amazon link below.

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