What to Look for in a Gender-Affirming Surgeon

Choosing a gender-affirming surgeon is a huge decision—one that can come with excitement, nerves, and a million questions. If you’re feeling overwhelmed or unsure where to start, you’re not alone. This guide is here to walk you through the process so you can feel more prepared, informed, and supported every step of the way.

Credentials and Experience

Before you get started, it’s important to check the basics.

• Board Certification: Make sure your surgeon is board-certified in plastic surgery or the specialty relevant to your procedure. This means they’ve completed rigorous training and testing.
• Specialized Training: Ask whether they’ve had additional training or fellowships in gender-affirming procedures. Not all plastic surgeons have this expertise.
• Experience: How many years have they been performing this specific surgery? How many procedures have they done for patients with goals similar to yours? Look for a consistent track record of outcomes—not just one or two great photos. It’s okay to ask to see a range of results and to ask about complications or revision rates.
• Accredited Facilities: Surgeries should be performed in accredited hospitals or surgical centers. Accreditation means regular safety checks and high standards. Hospital affiliations can also matter—if something unexpected happens, you want to know you can access hospital care quickly.
• Reputation: Check for any disciplinary actions or malpractice claims. A quick online search or a visit to your state’s medical board website can usually provide this information.

It’s perfectly okay to ask these questions directly! Any reputable surgeon will answer them without hesitation. Credentials, skill, and experience aren’t just “nice to have.” they’re non-negotiables.

Green Flags: Signs You’ve Found a Good Fit

• Respectful, affirming communication
• Takes time to listen rather than talking over you
• Clear, unrushed answers
• Honest about risks, healing, scarring, timelines, complications, and revision rates
• Experience working with trans patients—and genuine enthusiasm about it
• Diverse before-and-after photos (across race, size, and body type)
• Staff consistently use correct names and pronouns
• Uses evidence-based guidelines (such as WPATH)
• Explains their surgical style and helps you decide whether it aligns with your goals
• Transparent about aftercare and ongoing support

Red Flags: When to Pause or Walk Away

• Avoids questions or gives vague answers
• Misgenders you or speaks in a dismissive or condescending way
• Little or no diversity in before-and-after photos
• Dismisses your goals without explanation
• Refuses to discuss complications or healing realities
• Poor communication or follow-up (in consults or reviews)
• Focuses more on payment than on your care

Look for Results on Bodies Like Yours

When you’re reviewing before-and-after photos, don’t just skim. Really look for people whose bodies, features, and goals are similar to yours. Make sure the surgeon has experience working with a range of bodies and knows how to deliver results that look great on people like you.

• Body Size and Shape: Seek out photos of patients with similar body size, chest shape, facial structure, or fat distribution. A great surgeon will have a diverse portfolio, not just “one look fits all.”
• Skin Tone and Texture: Scarring, healing, and results can look different depending on skin tone and texture.
• Surgical Style: Notice the surgeon’s aesthetic: do they create soft, rounded results or sharper, more angular lines? Minimal scarring? Do they use drains, or do they use a surgical method that removes the need for them? Make sure their style and method matches what you want.
• Range of Outcomes: Ask to see a variety of outcomes, including those that might be closer to your starting point or that show a range of healing stages.

Your anatomy is your starting point, and even the best surgeon can’t copy-and-paste someone else’s results onto your body. A good surgeon will help you understand what’s possible for you, set honest expectations, and support your desired outcome.

Reviews and Community Feedback

Don’t just rely on a surgeon’s website or what you hear in the consult. Dig into real stories from real people. Community feedback is one of the most powerful tools you have for getting the full picture.

• Where to Look: Go beyond Google! Check Reddit threads, TikTok and Instagram posts, Discord groups, Facebook communities, and transition vlogs on YouTube. Many trans folks share detailed experiences, tips, and even photo timelines of their journeys.
• What to Look For: Pay attention to patterns, not just one-off reviews. Are patients consistently happy with their results? Do they mention feeling respected and affirmed? How does the surgeon handle complications or revisions? Are there any recurring issues with communication, billing, or aftercare?
• Ask Around: If you’re comfortable, post in trans support forums or groups asking for experiences with a specific surgeon or clinic. Many people are happy to share honest feedback, both the good and the bad.
• Red Flags in Reviews: Watch for repeated concerns about misgendering, lack of follow-up, hidden fees, or feeling rushed or dismissed. One bad review isn’t everything, but a pattern is worth noting.
• Peer Support: Connecting with others who’ve been through the process can make a world of difference. They can offer practical advice, emotional support, and even recommend questions you might not have thought to ask.

Remember: Every journey is unique, and no surgeon will have a perfect record. Focus on how they respond to problems and whether former patients would choose them again.

Money, Insurance, and Logistics

Surgery is a big investment. Getting clarity up front can save you stress and surprises down the road.

• Insurance Coverage: Ask if the surgeon accepts your insurance and what procedures are covered. Find out what documentation (letters, referrals, proof of so many months of HRT) you’ll need for approval, and whether the office helps with insurance paperwork or appeals.
• Out-of-Pocket Costs: Request a detailed breakdown of all costs, including surgeon fees, anesthesia, facility charges, lab work, and supplies. Ask about payment plans, sliding scale options, and required deposits.
• Pre- and Post-Surgery Expenses: Don’t forget about the “extras”, like pre-op appointments, lab tests, travel, lodging, medications, follow-up visits, and any supplies you’ll need for recovery. These can add up quickly.
• Transparent Pricing: A reputable surgeon will be upfront about all fees and billing timelines. If you get vague answers or see hidden costs, consider it a red flag.
• Waitlists and Scheduling: Ask about current wait times for consults and surgery dates. Some surgeons book out months (or even years) in advance.
• Aftercare Support: What does post-op support look like? Are follow-up appointments included? 
• After-Hours and Emergency Support: Find out who to contact if you have a complication or urgent question outside regular hours. Is there a nurse line or on-call provider?
• Revision Policies: Ask what happens if you need a revision or additional procedure. Is there a cost? How do they handle dissatisfaction or complications?

If you want help understanding how surgical fees are structured and why costs vary so widely, you can read our guide Breaking Down Your Surgery Quote: Understanding Fees and Costs. This breakdown can give you a clearer picture of what to expect and how to compare different surgeons’ estimates.

If your insurance denies coverage, don’t panic! Appeals are common, and many people win them. Our guide My Insurance Has Denied My Gender-Affirming Surgery. Now What? walks you through the next steps, timelines, and tips on navigating the appeals process.

Accessibility Matters

Accessibility is a real gap that many trans folks encounter on their care journey, whether it’s related to mobility, disability, neurodiversity, chronic pain, transportation, or sensory needs. 

If you have access needs, don’t hesitate to ask how the surgeon or the clinic supports disabled or neurodivergent patients. This might include things like wheelchair access, adjustable surgical positioning, sensory accommodations (like quiet waiting areas or dimmed lights), help with paperwork, or extra time during consults for processing or communication.

You deserve care that meets your whole self, and a good clinic will welcome these conversations and work with you to find solutions.

A Note on Racial Disparities in Care

We want to acknowledge that Black, Indigenous, and other trans people of color often face additional barriers in medical settings. These inequities can affect everything from the quality of care you receive to how seriously your concerns are taken. You deserve to be treated with respect, dignity, and cultural competence at every step of this process.

If you ever feel dismissed, unsafe, or unsure how to advocate for yourself, you’re not alone. It can help to bring a trusted support person to appointments, write down questions or concerns ahead of time, or ask for clarification or a pause when something doesn’t feel right. Seeking a second opinion or changing providers is also a valid and powerful form of self-advocacy.

Time for the Consultation

A little planning can go a long way to ensure your first interactions with a potential surgeon go smoothly and help you gather the info you need. We put together some gentle, step-by-step guides to help you feel more confident, grounded, and ready to get the answers you need.

• Your Gender-Affirming Surgery Consult Checklist
• Questions to Ask at Your Gender-Affirming Surgery Consult

Reminder: It’s Okay to Take Your Time

You might not find the right surgeon on the first consultation—and that’s completely normal. It’s okay to meet with more than one provider, to pause, or to walk away from a consult that doesn’t feel right.

Trust your instincts. If something feels off—whether it’s the communication, the environment, or how respected you feel—you’re allowed to keep looking. This is your body and your journey, and you deserve care that truly sees and honors you.

And if things don’t go exactly as planned, that doesn’t mean you failed. Seeking a second opinion, asking questions, or advocating for next steps like a revision following surgery is part of listening to yourself. Be gentle with yourself—you’re doing your best with something big and deeply personal.

Cheering You On, Every Step of the Way

Choosing a gender-affirming surgeon is a big, sometimes overwhelming step, but you don’t have to do it alone. Remember, it’s okay to move at your own pace, to ask every question (twice if you need to!), and to take all the time you need to feel confident in your decisions. You are worthy of care that truly sees and supports you, not just as a patient, but as a whole person.

Need help affording gender affirming surgery? Learn about Point of Pride’s Annual Trans Surgery Fund, which provides financial aid to trans folks who cannot afford or otherwise access healthcare.