Genitourinary reconstructive surgery is complex. This section of the website regularly updates the preoperative instructions.

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NOTE: Understanding Surgical Limitations

• Functional vs. Aesthetic: The goal of phalloplasty and metoidioplasty and their associated surgeries is to create a representation of male genitalia. Patients must accept that surgically constructed genitalia will not function identically to natal genitalia regarding erection, ejaculation, or sensation.

• No Psychological Guarantees: While surgery can alleviate anatomical dysphoria, it is not a cure-all for depression, anxiety, or social difficulties. We require patients to have a robust mental health support system in place, as surgery is only one component of a holistic treatment plan.

• Off-Label Usage: Patients should be aware that many surgical interventions in this field utilize medications and devices in an "off-label" capacity, meaning they are not specifically FDA-approved for the treatment of gender dysphoria.

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Regarding GLP1 medications: 

1. Continue GLP1 medications without interruption.

2. Patients on a GLP-1 will be instructed to have a Clear Liquid Diet the day of and before surgery. Patients who fail to abide by diet restrictions will have patient-centered shared-decision making regarding risks of anesthesia and GLP-1.

3. If gastrointestinal symptoms are present (like nausea, vomiting), there will be patient-centered shared-decision making.

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Examples of Clear Liquid Diet:

• Water: Plain or carbonated

• Tea/ Coffee: NO milk, NO milk substitutes, NO cream or non-dairy creamer

• Sport drinks: Clear

• Juices: Fruit juices without pulp (apple, cranberry)

• Clear broth/consommé (strained, transparent)