Gender Affirming Surgery

Question 1

What are the 3 prerequisites for top surgery?

Answer 1

• 1 letter from mental health professional
• 12+ months of documented hormone therapy
• 18+ yo

Question 2

What are the 3 prerequisites for bottom surgery?

Answer 2

• 2 letters from mental health professional
• 12+ months of documented hormone therapy
• 18+ yo

Question 3

T/F: there is currently no prerequisites for facial surgery.

Answer 3

true

Question 4

what are the 4 post-op instructions that every patient receives after a breast augmentation?

Answer 4

• clean wound daily
• implant massage
• no strenuous activity 4 weeks
• no underwire bra 4 weeks

Question 5

If a patient complains of breast discomfort and an implant in the wrong spot following breast augmentation what complication should you be worried about?

Answer 5

capsular contracture

Question 6

what grading system is used to define breast augmentation?

Answer 6

Baker Grade I-IV

Question 7

What is the treatment for a capsular contracture post-breast augmentation?

Answer 7

surgery and removal of capsule

Question 8

Following a mastectomy what red flags should you be looking for when removing the JP drain ?

Answer 8

symptoms of expanding hematoma, seroma

Question 9

with any facial gender surgery you must warn the patient about this adverse effect

Answer 9

the patient will be swollen!

Question 10

With a septoplasty/ rhinoplasty patients must avoid these 2 things.

Answer 10

• blowing nose

- wearing glasses or masks

Question 11

Following facial gender surgery how long can swelling persist for?

Answer 11

9-12 months

Question 12

how long is a typical vaginoplasty case?

Answer 12

8-10 hours

Question 13

Post-op vaginoplasty how often is dilation and douching required?

Answer 13

• dilation 2x daily

- douching every 3-4 days

Question 14

T/F: In a patient who underwent a vaginoplasty you DO NOT have to do a PAP smear.

Answer 14

true

Question 15

what is a red flag we look for during post-op stage I phalloplasty?

Answer 15

cold phallus concerning for flap loss

Question 16

scrotoplasty have higher rates of this complication

Answer 16

dehiscence

Question 17

what is a red flag we look for during post-op stage 2 phalloplasty?

Answer 17

decreased urine output into STP over 24 hours

Question 18

what are the 3 adverse effects of using the forearm as the donor site for a phalloplasty?

Answer 18

• neuroma (most common = radial sensory nerve)
• lymphedema
• vascular access is gone

Question 19

if a patient complains of urine being trapped or “sitting on fluid” following a phalloplasty what should you be concerned about?

Answer 19

diverticulum

Question 20

If a patient complains of urine leaking from a site other than the urethral meatus following a phalloplasty what should you be concerned about?

Answer 20

fistula

Question 21

If a patient complains of difficulty emptying the bladder, urgency, bladder fullness, or post-void dribbling following a phalloplasty what should you be concerned about?

Answer 21

stricture

Question 22

T/F: a patient who underwent a phalloplasty has no prostate.

Answer 22

true

pain never prostatitis`

Question 23

What is the WPATH surgical criteria?

Answer 23

• 18+ yo
• 1-2 letters from mental health professional
• no contraindications to surgery
• evidence of a good support system
• hormone therapy for 1 year
• social transition (name change, etc.)