Pre & Post-Op Supplies You Will Need

For those considering sex reassignment surgery, I thought I'd make a convenient piece on what is involved and what you'll need to prepare:

Before surgery, you will need some things in preparation. Some of it is provided by the hospital, some you'll have to buy. I would also recommend buying the things you'll need for after surgery before you go too because you will not want to go out to get supplies while you're recovering. First, you WILL need a buddy. Recovery is rough. You will be exhausted, weak and it's hard to get around. Plan to have a friend or family member available to cater to you for at least one week after you get out of the hospital. Mount Sinai demands patients have a helper be available 24/7 for at least three weeks or they might not allow you to get the surgery. Trust me, I wouldn't have been able to take care of myself alone. You will be provided the bowel prep drink by prescription and will have to drink the entire thing the day before surgery. It's not the best tasting thing in the world. I'd recommend refrigerating it before drinking. It helps. You are going to need health insurance. Unless you are a rich mofo, and by rich I mean millionaire, you WILL need health insurance that covers the entire procedure. The peritoneal graft method alone triples the cost of the surgery, bringing the total to over $160,000. This does not include the hospital stay, prescriptions, ambulance rides, nursing visits to your home or in the event of complications, another massive chunk of change because you had to go back to the hospital (in my case, that cellulitis infection was another $25,000+ billed to my insurance). I've blasted passed $200,000 in costs straight to my insurer. Beyond medical costs, the cost of travel to and from the hospital, including followup appointments is not cheap. It's New York City and each visit to Dr. Ting for a followup costs me about $75 to $100 in gas, tolls and parking. Even if your insurance pays your entire bill, I'd recommend saving a few thousand dollars for any other costs that may pop up. Beware of dreaded deductibles, co-insurance and the grand old "non-covered expenses" that can fuck you in a heartbeat and send you into medical bankruptcy. So also make sure you have a source of income to make installment payments should you end up hit with a big out of pocket bill. I was told by the billing people that Mount Sinai offers payment plans. Lastly, you will need two letters of recommendation for surgery, written to WPATH standards. The staff at CTMS will help you if you have trouble with these letters. You require one letter from an MD doctor and a second from a psychiatrist, therapist or psychologist. My letters were written by my endocrinologist and my psychotherapist.

-Buddy/Friend/Family Member/Paid Aide
-Bowel Prep Drink (prescription)
-Savings/Money
-Health Insurance
-Two Letters of Recommendation For SRS (one from MD doctor, one from psychiatrist/therapist)


After surgery and having the vaginal packing, catheter and wound vac removed, you begin dilation. Aftercare is important, especially when it comes to dilation. The important supplies were provided by the hospital. They gave me a set of dilators, MetroGel antibiotic lubricant (metronidazole gel), pain medication, stool softener and antibiotic pills. After a week and a half I no longer needed hardcore pain medication, so I stopped taking my Oxycontin prescription and switched to Tylenol Extra Strength as needed. I'd recommend a big bottle of Tylenol. For a few weeks after, you'll be sore when you stand and walk, especially if it's for longer than 10 minutes. All the swelling makes you feel a lot of sore pressure in the surgery site. It also helps with any soreness during dilation. Pop a couple Tylenol an hour prior. You're going to need something to sleep on and lay on during the day. You'll bleed overnight, and especially during dilation. Get menstrual pads to help absorb blood and fluids. It's not that bad, but when you're sleeping for several hours, stuff drips out over time. By one month post-op, you shouldn't need menstrual pads anymore. If you received the peritoneal graft, you will have to switch to panty liners to help absorb any peritoneal fluids that leak out from the vagina throughout the course of the day and night. During dilation, between the blood and the lube, it'll get messy. Waterproof bed-sheets or absorbent bed pads will prevent you from getting stuff all over your good sheets or through and onto your mattress. Paper towels, tissues and a ton of 3 inch to 4 inch gauze pads are a must for clean up. Buy an antibiotic ointment like bacitracin or Neosporin to treat sore spots or open wounds. Keep them covered with gauze overnight to help them heal. You might want to get more laxatives after your stool softener prescription runs out to help keep your poop softer. For the first few weeks post-op, you don't want solid poops and you're not supposed to strain (aka pushing) when doing a number two. Buy fiber gummies to help your poop too. You can't sit upright for about a month at least, maybe two. You're not supposed to put any pressure on the surgery site and it is still somewhat uncomfortable after several weeks. The hospital provided me a free butt donut to sit on, but you might need to buy one. Donuts are a godsend and make everything so much more comfortable, especially car rides to and from appointments. Eventually you might need tweezers to help pull out the stitches as they dissolve and come loose. When the MetroGel lube runs out, I started using simple K-Y water-based jelly lube. Buy lots of lube. LOTS. Dilating twice a day, everyday, eventually up to three or four times a day, you'll need it. A hand-held mirror is very helpful for being able to see what you're doing. It didn't take long to start figuring out how to dilate by feel, but it's also good to keep close watch of your healing progress and inspect yourself for possible complications or infection. Speaking of infection, buy a thermometer to monitor yourself for fevers, especially during the first couple weeks post-op. You might not feel feverish, but check yourself a few times a day anyway. I'd recommend large ABD pads to use as a crotch cushion for when you have to wear pants. It helps with comfort. For the first two or so weeks, you'll want comfy yoga pants. Jeans are just too tight on the surgery site, even with ABD pads. By three or four weeks, jeans are okay with ABD pads to cushion your crotch. I suppose long skirts would also work for when you must go out in public or to appointments. Skirts and dresses may be better for while you still have the catheter and wound vac installed. Swelling is going to make peeing messy for a while, so beware of spray. I highly recommend a women's camping pee device like GoGirl to help contain the spray and send it out in a controlled stream. Be sure to clean it after every use. With such frequent dilation, you may occasionally need to flush out the vaginal canal. Periodically maintaining the interior should help flush out dried lube left behind, dead skin cells that shed over time and urine or other things that manage to get in there. Early on, I'd recommend a douche device filled with purified or distilled water be used once every couple of weeks at least.

-Dilator Set
-MetroGel (prescription)
-Pain Medication (prescription)
-KY Water-based Jelly
-Paper Towels
-Tissues
-3" to 4" Gauze Pads
-Absorbent Bed Pads or Waterproof Bed-sheet
-Hand-held Mirror
-Bacitracin or Neosporin
-Menstrual Pads
-Panty Liners
-Fiber Gummies or Supplements
-Thermometer
-Butt Donut
-Tweezers
-Extra Strength Tylenol
-Laxative/Stool Softener
-ABD Pads
-Yoga Pants or Long Skirts/Casual Dress
-GoGirl pee funnel or similar device
-Douche device
-Distilled or Purified Water