Vaginoplasty patient journey

Vaginoplasty journey

• Waiting for intake

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  Once the Gender Surgery Program B.C. (GSPBC) has received your referral package, your GP will be notified, and our clerks will email you a welcome package. 

  The wait time from accepted referral to intake appointment can be 12-16 months. Please note this wait time can vary. During this wait time you can begin to prepare yourself for surgery as much as possible. This can include working on stopping smoking, improving your overall health and wellness, putting money aside, working to find a GP, and many more important pieces of readiness.  

• Intake and first surgical consultation

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  Your first appointment with the Gender Surgery Program B.C. (GSPBC) will be an intake appointment over the phone with one of the GSPBC Nurses. The purpose of this session is to confirm your medical history and get a full sense of how best we can support you.  

  At a later date, you will then meet with a surgeon. This appointment typically happens via zoom. They help provide more information about your surgery, answer questions, and help determine steps to move towards surgical readiness. For full-depth vaginoplasty patients, this often includes starting on the process of hair removal. 

• Hair removal (full-depth vaginoplasty only)

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  The Gender Surgery Program B.C. (GSPBC) currently offers a few different hair removal pathways. These pathways may involve only intra-operative hair removal, full-preoperative hair removal using laser or electrolysis, or a hybrid approach of roughly 4-6 preoperative hair removal clearances combined with intra-operative hair removal. The surgeon will help you to determine which pathway is best for you. 

  The process of hair removal takes different amounts of time for each person depending on pathway selected and your body/hair type. 

  Please note that any hair removal completed prior to your first surgical consultation will not be eligible for reimbursement or refund. 

  For more information on hair removal please see our resource documents below.

• Second surgical consultation

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  This consultation is a check-in on your surgical readiness and helps to determine if any additional steps are needed. If all steps are completed, you are deemed surgically ready and added to a wait list for surgery.  

  Please note the second surgical consult is typically completed in person and may require a physical examination that includes one of the surgeons looking at your current genitals to help plan for your surgery. You are welcome to bring a support person with you into the clinic room. 

  If you are traveling from out of town for this appointment and have concerns regarding this trip – you can look into options for reducing cost. We are happy to provide a TAP form if you are taking a ferry. Hope Air is a charity that can assist with transportation depending on eligibility. You may also request a phone call with the Gender Surgery Program B.C. (GSPBC) Social Worker if you are experiencing barriers to coming to our clinic. 

• Preparing for surgery

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  While waiting for your surgery date, there are things you can work on to be as prepared as possible.  

  You will have allied-health appointments virtually to help identify these areas. You will meet with the Gender Surgery Program B.C. (GSPBC) Social Worker for an assessment, and to help prepare multiple kinds of supports, travel, accommodation, and a post-surgery support plan. 

  For vaginoplasty, we ask patients arrive to Vancouver 1-2 days prior to surgery and stay in the Lower Mainland area for 2 weeks following hospital discharge. This local stay will allow you to be closely monitored by the GSPBC team and be nearby in the event of a post-surgical emergency. 

  The social worker will help to determine if you can apply for resources to off-set the cost of this local stay. To help prepare, you may begin reaching out to family members or friends that you could potentially stay with or beginning to put aside money. 

  You will also check-in with the GSPBC Pelvic Floor Physiotherapist for an assessment. This appointment is typically completed via zoom. During this appointment, they will teach you about your pelvic floor muscles and how you can prepare this area for the impact of surgery. If you are planning to have full-depth vaginoplasty, having good control of your pelvic muscles is very important for dilation. 

  When a surgical date is offered to you, you will receive further education on your surgery. An Enhanced Recovery After Surgery (ERAS) booklet will be reviewed with the clinic nurse. 

  To learn more about how you can prepare for your upcoming surgery, read our guide to preparing for gender-affirming surgery. 

  Surgery Wait Times 

  Once you are added to the surgical waitlist, a GSP nurse will connect with you to discuss wait times. Please note that the wait time for surgery fluctuates constantly. This is mainly due to the amount of operating room (OR) time our program receives. GSPBC receives OR time in roughly 3 month intervals and the amount of OR time we are given each month often changes – making it very difficult to predict wait times. We estimate the average wait from consent to surgery to be 10-12 months, but this is highly variable

• Surgery

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  Your surgery may be at Vancouver General Hospital (VGH) or UBC Hospital (UBCH) – depending on availability. 

  You can expect to be in the hospital 6-8 days following vaginoplasty surgery. During your hospital stay you can have visitors between 9:00am – 9:00pm.  

  During your stay you will have packing that keeps your vagina open and a urinary catheter. GSPBC clinicians will come see you in the hospital prior to discharge to remove these and teach you how to dilate.  

• Post-surgery

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  You can expect to have 1 appointment per week for the first 8 weeks. The first 2-3 appointments will be in person for all patients. If you do not live in Vancouver, we switch to phone appointments once you return home. If you do live in Vancouver, we will continue to see you in person.  

  Things to know: 

  • Expect swelling and bruising, some minor bleeding is normal
  • Labia may be uneven; it will take 6-12 months for swelling to resolve
  • Expect fatigue, walking will be slow initially, limited sitting
  • Lots of time without underwear and/or pants during the initial recovery
  • Dilation 3x daily for 15 minutes each 

  You will have a check in post-op with the GSP social worker and pelvic floor physio. They will continue to meet with you as needed during your recovery. 

  Gradual return to activity/work around 6 weeks (depending on work and healing) 

  After the first 8 weeks, your follow-up will be tailored to your specific healing. You can expect to come back to the clinic at 6 months and 1 year for in person check-ins with the surgeon. You may have additional appointments between these as needed. 

  Typically, at the 1-year mark patients are discharged into the care of their family doctor or community. Please see our post-discharge document for more information.