Center for Gender Surgery | Eligibility for Surgery

*Please note: Scheduling of patient procedures depends on a number of factors, including your health, the insurance authorization process, when you were initially seen, and other individual needs. We strive to schedule patients equitably and ethically to maximize efficiency and provide the best possible care to everyone. Center staff cannot discuss any information about other patients, including scheduling of procedures.*

Surgery is never the first step in a gender transition. It is something that happens after you have already explored social and medical transition options. People who choose to undergo surgery usually do so after taking other steps in the gender affirmation process, such as taking supplemental hormones.

Please note: You cannot smoke or vape (cigarettes, marijuana or other substances) or have any other nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery. Doing so may delay your procedure and increase the risk of serious complications.

To qualify for gender affirmation at Boston Children's Hospital, you must be at least 18 years old for phalloplasty or metoidioplasty and at least 17 years old for vaginoplasty.

You must also have the following:

  • A letter from a medical doctor or nurse practitioner stating that you have "persistent, well documented, gender dysphoria" and specifying the length of hormone therapy.
  • A letter from your regular therapist stating that you have "persistent, well documented, gender dysphoria," that any significant mental health concerns are well controlled and that you have been living full time in your identified gender for at least 12 months.
  • A second letter, from a mental health professional familiar with the procedure you are seeking, stating you are ready for surgery. This should include your understanding of the surgery procedure and recovery needs, fertility implications of surgery, and risks of surgery. It should also state that you are able to consent for surgery and include an assessment of your support systems.

Patients who want to pursue chest surgery must be at least 15 years old and have the following:

  • A letter from a medical doctor or nurse practitioner stating that you have "persistent, well documented, gender dysphoria" and specifying either the length of hormone therapy or why you are not taking hormone therapy.
  • A letter from a mental health provider stating that you have the capacity to consent and that any significant mental health issues are being addressed.

Read the specific eligibility requirements for each procedure in these downloadable PDFs: