Fifty-eight and just referred to a gender clinic. Am I too old for surgery by the time I get seen?

I have been reading this board quietly for most of the year and finally have something to ask.

I am 58. I have known since I was about seven and spent fifty years not doing anything about it, for reasons that were good ones at the time. My GP referred me in August. She was kind, but she also said, quite gently, that the wait for a first appointment is "several years", and I went home and did the maths, and by the time I get anywhere near a surgeon I will be well into my sixties.

I have high blood pressure (controlled) and I am about two stone heavier than I would like. I do not smoke.

So the questions I keep turning over at 3am. Is there an age when they just say no? Is surgery at 63 or 64 even sensible? And am I going to sit in a waiting room full of 20 year olds feeling like somebody's grandmother, because I am somebody's grandmother.

Maureen, welcome, and please do not feel like a grandmother in the waiting room, or rather do, and be proud of it. The waiting room at my clinic had a woman in her sixties at almost every appointment I went to. You will not be the only one.

The blood pressure and the two stone are the useful bits of your post, honestly, because those are things you can work on during the wait and they are much more the kind of thing a surgeon cares about than the number on your birth certificate.

A woman I know had her surgery at 64. She said the pre-op assessment was longer and more thorough than her younger friends', and the recovery was slower, but nobody once suggested she was too old.

Maureen, thank you for writing this, and welcome. I want to answer the 3am questions properly, with the honest caveat that I am not a clinician and the people who can assess you are your gender service and, later, a surgical team.

Is there an age when they say no? Age on its own is rarely the deciding factor. The standards most services work to, WPATH SOC-8, frame assessment around capacity to consent and a discussion of any health conditions that could affect the outcome, and set no maximum age. Individual surgeons sometimes have their own policies, so it is a fair thing to ask directly when you get there.

Is surgery at 63 or 64 sensible? That is a question about your health, not your age, and it is one a surgeon answers after looking at your heart, lungs, blood pressure, weight and any medicines. Mara is right that the controlled blood pressure and the weight are the bits worth putting effort into now, with your GP, so they are not the reason for a delay later. The oldest woman in my own support group had her surgery at 66.

One practical thing, given the wait: when you get your first appointment, ask early which surgical options are realistic for you and on roughly what timescale. Some people later in life weigh options differently, for instance vaginoplasty against vulvoplasty, because of the lifelong dilation routine. I wrote up how that choice gets weighed in vaginoplasty vs vulvoplasty: deciding between them, including what lifelong dilation actually involves.

Jessica Tran said:

That is a question about your health, not your age

I have read that line out loud to my wife. She said "well then we had better go for walks". So we are going for walks.

Booked a GP review for the blood pressure and asked about the weight programme while I am there. It feels good to have something to do with the wait other than count it.

Late to this but just wanted to say: the woman next to me on the ward in August was 61, had her daughter visiting every afternoon, and was the calmest person on the whole floor. You are in good company, Maureen.