Preparing for Gender-Affirming Surgery: Pre-Op, What to Arrange and Pack

Preparing for gender-affirming surgery means three things: meeting the clinical pathway, getting your body ready, and arranging your home and support for recovery. Under WPATH SOC-8 (2022), most genital surgery asks for one referral and usually about 12 months of continuous hormone therapy where hormones are not contraindicated¹. Good preparation is the part most within your control, and it shapes how the early weeks feel.

The weeks before my own surgery were when I most wanted a plain checklist rather than reassurance, so here it is, checked by a consultant gender-affirmation surgeon: the pathway steps, the pre-op assessment, what to arrange at home, and what to pack. This article sits within our guide to gender-affirming surgery.

Meeting the clinical pathway

Preparation starts with the pathway, because surgery follows assessment, not the other way around. Under WPATH SOC-8 (2022), most genital gender-affirming surgery asks for one referral from a qualified health professional, after SOC-8 simplified the older two-referral norm, plus usually about 12 months of continuous hormone therapy where hormones are not contraindicated¹.

On the NHS, you reach surgery through a Gender Dysphoria Clinic pathway, with assessment and onward referral². For the route, see the pathway to gender-affirming surgery.

The pre-op assessment

The pre-op assessment checks you are ready for surgery and anaesthetic. It reviews your health and medication, may include blood tests, and is where instructions about hormones, eating and drinking before surgery, and what to bring are confirmed³.

Whether to adjust hormones around surgery varies by procedure, surgeon, and your individual clot risk, so follow your team’s specific instructions rather than a general rule. The assessment is also a good moment to ask any remaining questions.

Planning your time off

Plan time off in line with the procedure, not a single figure. As guide windows: about 6 to 8 weeks off work for vaginoplasty, and about 4 to 6 weeks for top surgery or metoidioplasty¹. Phalloplasty is staged and the longest of all.

Book the time before the day, and build in a buffer, since healing does not run to a fixed schedule. For procedure-specific timelines, see vaginoplasty recovery and top surgery recovery.

Arranging your home and support

Before the day, arrange help at home, prepare easy meals, set everything you use within easy reach, and stock loose clothing, since lifting, bending, and reaching are limited in the early weeks. Practical help in the first week makes the biggest difference to how recovery feels.

The single most useful thing I did before my surgery was set up the house so I barely had to reach or bend for a fortnight: meals ready, chargers and water by the bed, nothing important on a high shelf. It sounds small; it was not.

What to pack, and procedure-specific prep

Pack loose, comfortable clothing that is easy to put on without reaching, any regular medication, toiletries, phone and charger, and something for the quiet hours. For vaginoplasty, your dilators and dilation routine are part of preparation, because dilation begins in hospital and is a lifelong practice¹.

Knowing that the dilation routine starts in hospital, rather than weeks later at home, was something I wish I had grasped earlier. To prepare for that specifically, see vaginoplasty recovery. Nothing here is personal medical advice; always follow your own surgical team’s instructions.