Preparing for surgery

There are lots of things to think about when preparing for surgery, so we hope you’ll find this page useful.

If you have a job, it’s important to be familiar with the sick leave policy and the transition at work policy (if your employer has one). Make sure you understand if there are any time limits on paid absence and whether leave for transition related surgery will count towards your sick leave allowance.

You don’t have to tell your employer what type of surgery you’re having, but you will need to let them know that you’ll be off. You’re likely to be asked to provide a sick note – this is something the surgical team or your GP can provide you with, just ask them.

If you’re in education, talk to your personal tutor about the planned absence. As with an employer, you don’t have to tell them what type of surgery you’re having, but you will need to let them know that you’ll be off. You might also need to ask for extensions to some of your work deadlines.

Think about how you’ll get to and from hospital for pre-op and post-op appointments as well as for surgery itself.

Remember that for most surgeries, you’ll need someone to accompany you home from hospital and you won’t be able to drive yourself.

When planning for travel after surgery remember that you’ll have less stamina than usual, may be less able to walk than usual and that it’ll be a good idea to avoid very crowded forms of transport (for example, a tube train at rush hour).

It’s important to be aware that hospitals often require patients to arrive early in the morning on the day of surgery, so you might wish to stay nearby the night before if you live a long way from the hospital.

There will be follow-up appointments after surgery, so some people choose to stay near the hospital for a short while after surgery too.

When choosing your accommodation, consider:

  • Will I feel safe recovering from surgery here?
  • Will I have easy access to clean, private washing and toilet facilities?
  • Will I have easy access to healthy food when I need it?

Have a plan B for transport and/or accommodation. For example, what would you do if:

  • You’re in hospital longer than expected?
  • There’s a train strike?
  • The person driving you to hospital is ill?

It’s a good idea to book your travel and accommodation as far in advance as possible, as it will be cheaper. However, it is also sensible to book the most flexible options (for example, paying slightly more and having the option of cancelling your hotel or travelling home on a different train).

If you’re travelling abroad for surgery, take a look at our Travelling abroad for surgery page.

Some people are eligible to claim their travel costs back from the NHS. If you’re in Scotland or Northern Ireland or if you are a low income and living in England or Wales, take a look at our Help With Travel Costs page before taking any steps to book your transport or accommodation.

There are financial considerations to make for everyone having transition related surgery, even if you are having it on the NHS.

Some things you might have to budget for:

  • Specific items to take to hospital or to use during recovery
  • Travel to/from hospital and appointments. If you’re in Scotland, Wales, or Northern Ireland or if you are a low income and living in England, take a look at our Help With Travel Costs page to see what support you can access with this.
  • Extra prescription costs for medication and dressings (if you pay for your prescriptions). You might be able to reduce these costs with a prescription prepayment certificate.
  • Accommodation near the hospital if you live far away from it.
  • Additional support hours if usually have carers or support workers coming to help you at home. You might be able to have a temporary increase in funded support hours – talk to the care agency and to your social worker about this.
  • Increased food costs if you might have to rely on convenience foods.
  • Increased heating and electricity costs if you’re not normally at home during the day.
  • Costs associated with being off work. For example, any periods where you’ll be on statutory sick pay rather than your usual rate of pay or any unpaid leave you might need to take. If you work, check what workplace policies apply to you taking surgical leave.

Having surgery is a big event and it can impact your emotions in lots of different ways, including ways that might surprise you.

How might my mental health be impacted?

Everybody is different, but here are some things that might impact you and things you might want to do to prepare:

  • Anxiety relating to the operation, the hospital stay, travel, or being away from home. It can be really useful to identify make a plan about how you can manage this, even if you don’t normally struggle with anxiety. For example, you might want to try some relaxation techniques or make a list of activities that help you to feel calm and relaxed. Take a look at our Wellbeing and Self Care Hub for resources that might help you to manage your anxiety.

  • Excitement and post-op euphoria. These are quite nice, enjoy the feeling!

  • Post-op depression. This is incredibly common and doesn’t only impact trans people. It is so common that a surgeon was able to tell our researcher that it typically happens 3 or 4 days after surgery.

    By making arrangements for friends and family members to come and visit you in hospital (if possible) and when you’re recovering, you can put a support network in place for yourself. If it’s not possible for people to visit you in hospital, make a plan to have video calls or phone calls instead.

  • Frustration. This could be frustration at being less independent than usual, at being less mobile than usual, healing taking longer than you thought it would, or at things not going how you expected them to. Remember to be kind to yourself and plan ahead by finding ways that help you cope with feelings of frustration.

  • Current or previous mental health issues being triggered. It’s good to be aware of any specific triggers you may have in relation to a hospital stay, surgery, or recovery. For example, people with a history of drug addiction might find the experience of being given morphine challenging.

    People with previous negative experiences in hospital might find that a hospital stay is more challenging than it would be for other people. It can be helpful to talk to the surgical team about these triggers as it might be that they can do things a bit differently or might be able to put things in place to support you.

  • Changes in hormone levels. You are probably well aware of the difference your hormone levels can make to the way that you experience emotions and to your mood in general. Some surgeons will ask you to temporarily stop hormone therapy for a number of weeks before surgery. They do this due to risks around deep vein thrombosis (DVT) and pulmonary embolism and you’re typically able to re-start hormones soon after your operation.

    If this is something your surgeon requires, it’s important to mentally prepare yourself for the potential impact on your mood – both before surgery and during your recovery. Some people are more sensitive to fluctuations in their hormone levels than others. If you’re concerned, talk to your surgeon and ask them if they’d feel comfortable with you remaining on hormone therapy in the weeks leading up to surgery.

  • Complications or setbacks. For people that experience complications or setbacks in their healing it can be scary, frustrating and/or worrying. It’s important to be aware that no surgery is completely risk free and that it’s possible that you may experience complications or that the outcome of your surgery might not be quite what you expected.

    Some people have complications when they’re in hospital, others experience them in the weeks or months after surgery, and many people have no complications or setbacks at all. Your surgeon should tell you about these risks at your consultation and on the day of surgery.

    You can be proactive to reduce any stress associated with potential complications or setbacks. Be aware of the potential risks before you have surgery, find out about the support your GP practice can offer you, and make sure you’ve got friends or family members there to help you out during recovery. If you don’t have any friends or family members, your local trans support group might be able to help you out.

What can I do to prepare?

As well as the specific things we’ve already mentioned, there are a few things that you can do to prepare for the mental and emotional impact of surgery:

  • Build your support network. Talk to your friends and family, if you’re able to, about surgery and how you’re feeling about it. You might want to share this page so that they’re aware of how surgery can impact different people emotionally. If you don’t have any friends or family, be in contact with your local trans support group or local LGBTQ+ group – there might be people that are able to offer peer support.

  • Find out what the surgical team can offer. Some surgical teams have a psychologist within the team, or may have other options in relation to providing support for your emotional well-being in the lead up to surgery and during your recovery. Ask them!

  • Tell the surgical team and hospital staff about your communication needs. This is important if you find it hard to communicate about your feelings or if you are unable to speak when you feel overwhelmed, upset or stressed. Have a look on our Communicating about my needs page for some suggestions on how you could do that.

  • Find out about other people’s experiences. It can be useful to find out about other people’s experiences of surgery and about what they did to cope with the emotional impacts. Lots of people blog or vlog about their experiences, and some have written books about them too. Have a look around for what feels relevant to you.

    If you’re lucky enough to have trans friends that have had the surgery you’ll be having, ask them to tell you about their experiences and whether they have any top tips for you.
    There are lots of Facebook groups for people having different types of transition related surgery, so it might be a good idea to join the one(s) relevant to you before going into hospital. Sometimes they’re top secret, so ask around if you can’t find one.

There are certain things that your surgeon might ask you to do to prepare your body for surgery. For example, hair removal, quitting smoking or temporarily stopping taking hormones. Each surgeon will have different requirements, ask them if there’s anything you’re not sure about.

There are some other things that aren’t essential, but will be very useful in preparing your body for surgery and the healing process.

Things you could think about are:

  • Eating a healthy diet. Lots of people recommend eating plenty of protein and colourful fruits and vegetables. Colourful fruits and vegetables are rich in anti-oxidants and high in magnesium and vitamins C and K. Whole grains are a good source of vitamin B. These vitamins and minerals are thought to help with healing. Some people also say it’s a good idea to cut down on caffeine, alcohol and sugar.

    If you’re losing weight ahead of surgery so that you reach a target BMI, make sure you’re doing it in a healthy way. Extreme dieting could risk your health in general and could make it harder for your body to recover from surgery. There’s information on healthy weight loss on the NHS website and it’s something that you can ask your GP for support with. Some surgical teams have a dietician and/or can signpost you to sources of support. GDNRSS can also offer you some advice.

  • Stopping smoking. This is something that your surgeon is likely to ask you to do, and some surgeons will do a test before surgery to check that you’ve been honest with them. It’s important to also check their view on vaping or other nicotine products, as it’s not always the tobacco itself that is an issue.

    Smoking increases the risk of blood clots and chest infections, as well as impacting blood supply. Reduced blood supply can impact healing, post-op sensation and the success of skin grafts.

    There’s information on quitting smoking on the NHS website. You can also ask your GP or GDNRSS for support with it, and your surgical team might be able to signpost you to sources of support too.

  • Staying (or getting) active. We’re told that good levels of fitness can help make recovery easier. So stay active if you already are, or get active if you’re not already. There’s information about getting active on the NHS website. If the thought of stepping into a gym brings you out in a cold sweat, get creative. Go for walks, take the stairs instead of the lift if you’re able to, or dance around your living room. Hoovering also apparently counts as exercise.

It’s a good idea to talk to the people in your life about the support you might need from them after surgery.

  • Healthcare professionals. Tell your GP practice that you’re going to be having surgery, so that they’re aware. You can do this by contacting them and asking them to make a note on your health record. For most types of surgery, you’re unlikely to need additional support from them but it’s good that they’re aware in case you do.

    If you’re due to have phalloplasty or metoidioplasty, you’ll need a nurse to change your dressings whilst you’re recovering. A lot of people are able to travel to their GP practice for this, others need a district nurse to come and visit them. It’s a good idea for anyone due to have phalloplasty or metoidioplasty to chat to their GP practice about what support is available.

    Some people go to stay with a friend or family member whilst they’re recovering from surgery. If you’ll be recovering in a different town or city from your GP practice, you can register as an emergency patient at the practice that your friend of family member goes to. It’s a good idea to phone them in advance to explain that you’d like to do this, but it might be that you have to register with them once you’re out of hospital and need an appointment. This can feel stressful for people that like to be very organised, but try to trust in the process.

  • Local pharmacy. It’s useful to think about how you’ll access your prescriptions if there will be times where you’ll find it hard to go to the pharmacy. You’ve got a number of options here. You could ask your GP to prescribe more than usual to cover the recovery period, you could ask a friend or family member to take responsibility for collecting your prescriptions, or you could arrange for your local pharmacy to deliver them.

  • Friends and/or family. When recovering from surgery, it’s very useful to have supportive friends and/or family members around you.

    Different people will be good at different things, so think about who would be good at what (and who’s willing to help with what!). Recovery times will vary, but you’ll definitely need help for at least two weeks after surgery in most cases.

    Things you might need help with are:
    • Preparing food and drinks
    • Emotional support
    • Changing dressings – it’s a good idea to make they’re not squeamish
    • Washing and dressing – this isn’t the case for all people, but it is useful to think who could help with this if you need them to
    • Support in an emergency
    • Driving you to and from hospital and appointments
    • Keeping your home clean
    • Looking after your pets
    • Looking after your children
  • Support workers or personal assistants. If you usually have support from support workers or personal assistants, it’s important to talk to them (and the care agency if you use one) about your preparations for surgery. It might be that you need them to stay with you in hospital or that you need more support hours than usual. Talk to them about the support you might need from them while recovering and discuss in advance whether there are any things they won’t be able to help with. For example, they may or may not be allowed to help change your dressings.

The people in your life might have different levels of knowledge and understanding about transition related surgery. It might be that they need help to understand why people have surgery and what recovery is like. Sharing YouTube videos and books with them might be useful with this. For example, Top to Bottom by Finlay Games or Samantha Lux’s YouTube channel.

What you pack for surgery will depend on what type of surgery you’ll be having, how long you’ll be in hospital and on your own personal needs and preferences.

Your surgical team will usually provide you with a list of things to bring, however you might find the following items useful:

  • A list of what surgeries you’ve had and when, what medication you’re on, the phone number and address of your GP practice, the name and phone number of your emergency contact. Some people find it useful to keep all of this information together in a notebook.
  • Your communication passport if you have/need one. You’ll find links to template communication passports on the Communicating about my needs page. It might be useful to have two copies – one for your medical records and one to keep on your bedside table.
  • Resources to help you communicate if this is something you might find difficult. There’s more information on the types of resource you might use on the Communicating about my needs page.
  • Any medication that you take on a daily basis and any medication that you might need in an emergency, such as your Epi Pen or Inhaler.
  • A pen and paper or notepad. You could use this to write any questions you think of (and the answers) and any instructions you’re given around your recovery.
  • Slip on shoes or shoes with elastic shoe laces. You might not be able to bend down to put them on!
  • Loose, comfortable clothes for your journey home.
  • Pyjamas/nightie, dressing gown and slippers. Most hospitals will provide you with a hospital gown, a dressing gown and slippers or slipper socks but some people prefer to take their own with them.
  • A donut cushion or memory foam cushion (for lower surgery). This is for your journey home!
  • A lidded cup with a straw and/or bendy straws. It makes drinking whilst lying in bed easier.
  • A phone charger with a long cable.
  • A clothes peg or bulldog clip. You can use this to clip your charger cable to your bed sheets so that you don’t lose it!
  • Snacks. It’s a good idea to pack some that are high in fibre, as a lot of people experience post-op constipation.
  • Cough sweets. To soothe your throat if it’s irritated from the breathing tube used during surgery.
  • Toiletry bag. With deodorant, razor, toothbrush and toothpaste, comb. Most hospitals provide shampoo and shower gel.
  • Dry shampoo. If you wash your hair frequently, you might find this useful.
  • A hand mirror with a long handle (for vaginoplasty). This is to help when you’re dilating.
  • Wet wipes.
  • Lip balm. Your lips might get drier than usual.
  • Things to entertain yourself with! And chargers and headphones for any electronic devices. It’s a good idea to have downloaded some box sets or films in case the Wi-Fi connection isn’t very good.
  • Something that you find comforting from home.
  • Affirming items. For example some make up or a wig, if you wear one.
  • Fidget toys if you find them useful.
  • Earplugs or noise cancelling headphones. You might find it harder to sleep than usual.
  • Tissues
  • A funnel or STP device (for stage 1 phalloplasty and metiodioplasty). When your catheter is removed, the bruising might mean that your wee goes everywhere – including on your dressings. A funnel or stand to pee device can help to keep your dressings dry.
  • A rechargeable fan. Useful for people who get too hot in the summer, but also for people who experience (or might experience) hot flushes.

Some people take a box or bumbag to keep the things they want easy access to within reach. For example, you might want to put your important information, cough sweets, tissues, pen and paper, phone and phone charger in it.

Preparing your home before you go into hospital is important because there will be things you can’t do when you return home.

Some top tips for these preparations are:

  • Stock up on food. It’s helpful to have food in your cupboard or fridge that’s easy to prepare. If you like cooking, then do a bulk cook of healthy food to keep in your freezer. You might want to have dried fruits and/or liquorice to help with constipation, as this is commonly experienced after surgery.
  • Stock up on pain medication. It’s worth getting a good supply of paracetamol and ibuprofen in advance. You might not need it all, but it’s something you’ll use at another time anyway. Always follow your doctor’s instructions when taking pain medication.
  • Make sure everything is in easy reach. If there’s something you normally keep on a high shelf, at the back of a cupboard or under your bed and you think you’re going to want it when you’re recovering then now’s the time to find a temporary new home for it! You can move it back to the original place once you’ve recovered.
  • Prepare your bed. Make sure you have clean bed linen on your bed to prevent the risk of infection. Don’t use your best sheets though, use ones that you wouldn’t be worried about staining. A lot of people also use incopads or puppy pads on their bed to protect the sheets and mattress, an old towel would serve a similar purpose. If you’re going to have to sleep on your back or on a non-flat angle, have a bit of a try with your pillows and find an arrangement that works for you. Leave it all set up and ready for your return.

Other items you might want to check you have at home (in addition to those on your hospital list):

  • Toiletries. Scent free shower gel or body wash is important, as your skin will be more sensitive than usual. People having Radial Forearm Phalloplasty will benefit from shower gel with a pump action lid, as you’ll only be able to use one arm for a while.
  • Dry shampoo. If you wash your hair frequently, you might find this useful when you’re unable to shower.
  • Baby bath (for radial forearm phalloplasty). This is useful for soaking your arm in once allowed to.
  • A portable bidet (for vaginoplasty). You can use this to rinse your genitals after using the toilet when your wounds are still healing. See an example of a portable bidet.
  • Salt. Lots of salt for salt baths to aid healing. Only have a bath when your surgical team say it’s ok to.
  • Long-handled bath sponge. For those hard to reach areas.
  • Flannels. For a quick wash when you’re unable to shower.
  • Shower sleeve (for people having radial forearm phalloplasty). A binbag and some tape will serve a similar function.
  • Non-slip bathmat. This goes in the bath or shower and is useful for people who will be less steady on their feet or who might be less able to catch themself if they fall.
  • Moisturiser. You might find you’re washing your hands more than usual!
  • Hair dryer with cool mode. You can use this to dry yourself after a bath or shower!
  • Vaseline, Berpanthen or E45 cream. This can be useful for dry or irritated skin, but also for wounds. Check with your surgical team before using any creams on your wounds.
  • Fybogel or senna. To help with constipation.
  • Pain killers. See the information earlier on this page.
  • Antihistamines. In case of mild allergic reactions to dressings or medical tape. However, if you experience an allergic reaction, talk to a medical professional about it.
  • Anti-bloating medication such as buscopan (for hysterectomy). A lot of people experience bloating or trapped wind after a hysterectomy.
  • Probiotics. These can be useful to prevent stomach upsets if you’re taking antibiotics.
  • Arnica tablets. Some people recommend taking arnica tablets to support healing. It’s important to note that there is little medical evidence to support this.
  • Herbal tea. Ginger tea and peppermint tea are useful for nausea. Camomile tea might help you sleep.
  • Medical gloves. If someone will be helping you change your dressings.
  • Anti-bacterial handwash
  • Anti-bacterial cleaning wipes/spray
  • Medical tape
  • Non-stick medical gauze
  • Inadine. This is useful to have handy in case of infection or healing difficulties.
  • Scissors. Generally useful, but particularly useful for cutting bandages and dressings to size.
  • Scar care resources. Such as silicone gel and sheets or bio oil. Ask your surgeon what they recommend and follow their instructions.
  • A thermometer. So that you can tell if you’ve got a fever.
  • Ice pack
  • Hand mirror
  • A bed tray. This is a tray with legs that can go over your lap without placing pressure on your abdomen or groin. These are useful for putting your things on whilst in bed, but they will also prevent pets from sitting on you!
  • Incopads or puppy pads (for lower surgery)
  • Cheap or old bedding
  • Plenty of clean underwear. Go for cheap ones! For people having phalloplasty or metoidioplasty, you might need a larger size than usual or a more supportive style.
  • Clothes that are comfortable and easy to put on. For people having top surgery, button up shirts and zip up hoodies are ideal.
  • Sanitary towels (for vaginoplasty or hysterectomy). These help to prevent your underwear from any bleeding or discharge. If using sanitary towels would be too dysphoric, you could use a lightweight incontinence pad designed for men.
  • Lubricant (for vaginoplasty). You might be sent home with this, so check with your surgical team before buying any.
  • Sterile saline (for vaginoplasty). To use when douching in the first weeks after surgery.
  • Dilators (for vaginoplasty). In most cases, you’ll be sent home with these. Check with the surgical team.
  • Douche (for vaginoplasty). In most cases, you’ll be sent home with these. Check with the surgical team.
  • Post-surgery binder (for mastectomy). This is usually provided by the surgeon, check with them.
  • Catheter related resources (for stage 2 phalloplasty or metoidioplasty). These might include a night bag stand, spare catheter bags, and spare flip flow valves. In most cases, you’ll be sent home with these. Check with the surgical team.
  • Measuring container (for stage 2 phalloplasty or metoidioplasty). This is to use to measure your wee when you’re practicing having a wee through your new penis. Ideally it’ll be one that you don’t want to use for other things!
  • 10ml syringe (for stage 1 phalloplasty). In most cases, you’ll be given this by the surgical team. It’s to use when flushing your new urethra through with water.
  • V-shaped pillow
  • Memory foam or donut cushion (for lower surgery)
  • Long charging cable
  • Grabber. For picking things up off the floor, for helping you to get dressed, for use as a back scratcher if you don’t have one etc etc.
  • Long handled shoe horn. Primarily to help you put your shoes on, but if it has a hook on one end it’s useful for putting other clothes on too.
  • Plenty of things to keep you entertained!

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A disclaimer: TransActual do not provide medical, health, or legal advice. The content of this page is intended for information purposes only. It is not a substitute for medical advice, diagnosis or treatment from a medical professional. It is not a substitute for advice from a legal professional. We strongly suggest you consult a healthcare professional or legal professional for specific advice about your situation. TransActual do not advocate or recommend the purchase of any specific product and we do not endorse or guarantee the credentials or appropriateness of any health care provider, any product or any provider of insurance and legal services.

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