Preparing for gender-affirming surgery: a practical checklist

Time off, money, help at home, fertility, and the feelings that can turn up afterwards. What to sort out before surgery.

By Brydan Xavier, Director and Principal Psychologist 25 September 2026 About 4 min read

tl;dr

At a glance.

Plan time off, money, help at home and follow-up appointments early.
Check your surgeon’s letter requirements, including whether they accept a Registered Psychologist or only a Clinical Psychologist, and how recent the letter must be.
Private hospital cover can have waiting periods of up to 12 months.
Line up support for the first days and weeks, and think about fertility first.
Mixed feelings after surgery are normal, and support is there.

Surgery is a big step, and often a joyful one. It also goes better with some planning. This is the checklist we work through with people during a readiness assessment. Your surgeon and GP will have their own too.

Practical things

Time off. Ask your surgeon how long recovery usually takes for your procedure, then add a buffer. Work out leave from work or study early.
Money. Surgery, anaesthetist and hospital fees, travel and accommodation if your surgeon is interstate, medications and dressings, and time without income. There is currently no specific Medicare item for gender-affirming surgery in Australia, and private health cover varies, so ask your fund exactly what it covers.
Home. Who will help with meals, cleaning, shopping, pets and getting to follow-up appointments? Can you set things up at waist height before you go in?
Nicotine. Stopping smoking and vaping before and after surgery helps you heal. If that is hard, tell your GP and surgeon. You will not be judged, and there is help.
Hair removal. Some genital surgeries need laser or electrolysis hair removal first, which can take many months. Ask early.
Insurance waiting periods. Private hospital cover waiting periods can be up to 12 months. Check before you book.
Paperwork. Check your surgeon's letter requirements early. Many accept a readiness report for 12 months, some only for three. Also ask whether they accept a letter from a Registered Psychologist, or only from a Clinical Psychologist or psychiatrist.

Your support

Good support is one of the strongest things you can bring to recovery. It does not need to be perfect, and it does not need to be biological. Chosen family counts. So do friends, partners, housemates, community groups and services.

Try writing down:

who will be with you in the first few days
who can check in during the first few weeks
who you can call if you feel low
which services you can reach out to if those people are not available

Fertility

Some surgeries affect fertility permanently. Before surgery, talk with your surgeon and GP about whether you want to preserve eggs, sperm or embryos, what it costs and how long it takes. It is easier to think about this well before a surgery date.

Feelings

Many people feel relief, joy and a sense of finally being at home in their body. Some also feel other things: tiredness, frustration at slow healing, or grief for the years spent in a body that did not fit. Sometimes all of these in one afternoon.

That is normal. Surgery is one step in a much longer story, and it does not have to fix everything to be the right decision. If feelings get heavy, support is available, including from us.

Afterwards

Some people stop seeing a psychologist once their letter is done. Others keep coming for support before and after surgery. Either is fine.

If you are starting to plan, our gender-affirming care page explains how our readiness assessments work.

Questions

Quick questions.

When should I start planning?

As early as you can. If your surgery date is booked, contact us at least four months before it for a readiness assessment.

Does Medicare cover gender-affirming surgery?

There is no specific Medicare item for it. Private cover varies, so ask your fund exactly what is covered and whether a waiting period applies.

Who can write my letter?

It depends on your surgeon. Some accept a Registered Psychologist, some only a Clinical Psychologist or psychiatrist. Check first.

Can I get support after surgery?

Yes. Some people keep seeing us before and after surgery. That is always optional.

Free planning worksheet.

Write down your surgeon’s requirements, insurance dates, and who will help at home, in one place. It comes with our free client guides.

New clientsGet the free guides

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