The surgical process in gender affirmation is often a highly anticipated moment due to everything it represents on a personal level. For some trans people, surgery is part of a long and carefully considered journey. However, for their families and close circle, this step is also experienced very intensely. In this context, psychological support is not conceived as a filter, a requirement, or an identity test, but rather as a complementary tool aimed at improving the emotional experience before and after surgery, both for the trans person and for those closest to them.
Psychological support is an emotional resource focused on well-being, useful in any major surgery, but especially relevant when the intervention is linked to identity and the body. For this reason, we explain why, in some cases, psychological support in trans surgery is necessary.
It Is Not a Diagnosis: It Is Support
Under current professional standards (including WPATH SOC8), the role of clinical psychology has evolved toward a completely different model from that of years ago. Today, the goal is not to assess a trans person’s identity or to “validate” who needs surgery. That is not the role of psychologists, and at IM GENDER we never work from that perspective.
Psychological support is offered as a space where you can:
- Prepare emotionally for the entire process.
- Understand what to expect before and after surgery.
- Organize your expectations realistically.
- Reduce preoperative anxiety.
- Accompany bodily changes and the subsequent adaptation process.
It is similar to the support many people seek before any major surgery, but with special care given to the meaning the intervention has for the well-being, identity, and life project of the trans person. This approach fully respects self-determination and acknowledges that many trans people arrive at the surgical process with a long and solid emotional and social trajectory.
What Does a Psychologist Specialized in Trans Surgery Provide?
Although each process is unique, certain emotional reactions are common among people preparing for gender-affirming surgery. These reactions do not indicate emotional weakness or psychological disorder; they simply reflect the magnitude of the step being taken. This is completely normal and also occurs in other circumstances.
Anxiety Before Gender-Affirming Surgery
Preoperative anxiety is very common. In the case of gender-affirming surgeries, this nervousness may intensify due to the symbolic weight of the intervention, years of waiting, or the desire for results to meet personal expectations. It may also stem from the usual fears anyone may have when entering an operating room: the environment, anesthesia, fear of the unknown. Psychological support provides techniques and guidance to understand this anxiety and reduce its impact. Preparation for gender surgery is essential.
Expectations and Gender Surgery
Even with thorough medical information, expectations about outcomes often include idealized elements. Targeted psychological support allows these expectations to be reviewed carefully, integrating variables such as recovery time, tissue evolution, swelling, and sensory adaptation. Aligning expectations with reality helps reduce frustration and improves postoperative satisfaction.
Recovery and Postoperative Period
The first days and weeks after surgery are usually marked by swelling, discomfort, changes in sensitivity, and a provisional body image. Understanding that recovery is slow and that the initial appearance does not reflect the final result is an essential part of the process. Having clear information about recovery, understanding that each person is different, and having a supportive environment are key. Psychological support can offer strategies to manage uncertainty and tools to accept the natural pace of recovery and the postoperative period.
Psychological Support in Gender Surgery
Preoperative and postoperative psychological support is not intended to evaluate identities or condition access to surgery. Its objectives are practical, clinical, and focused on the experience of the trans person.
Emotional Preparation and Psychoeducation
A key component of support is psychoeducation: understanding the steps of the procedure, the role of anesthesia, recovery timelines, and common sensations. This information, integrated from an emotional perspective, helps reduce uncertainty and anticipate normal bodily and mental responses.
Anxiety Management
Many patients report anticipatory thoughts related to the surgical process. Psychological support may include emotional regulation techniques, coping strategies, and tools to reduce the physiological activation associated with fear or worry.
Supporting Adaptation to Bodily Change
Gender-affirming surgeries involve significant—and sometimes irreversible—bodily changes. Adapting to these changes, even when desired, may take time. Psychological support can facilitate integration of the new physical appearance, reconciliation between internal and external body image, and gradual acceptance of the new bodily representation.
Organizing Realistic Expectations
Expectations are one of the factors that most strongly affect emotional well-being. Even with detailed information from patient care teams or medical staff, professional psychological support can help build solid, realistic expectations aligned with surgical reality. This is essential to avoid misinterpretations during early recovery stages, when results are not yet final.
How Psychological Support Benefits Gender Surgery
Multiple studies in reconstructive surgery, general surgery, and health psychology show that emotional support before and after surgery:
- Reduces preoperative anxiety.
- Improves adherence to postoperative instructions.
- Decreases pain perception and increases the sense of control.
- Enhances overall satisfaction with the procedure.
- Contributes to better adaptation to significant bodily changes.
In gender-affirming surgery, patients who receive structured emotional support report a calmer surgical journey and a higher sense of well-being during recovery. As Dr. Labanca stated in an interview: “The success of gender surgery is not measured in millimeters, but in happiness.”
Who Can Benefit From Psychological Support?
Psychological support is optional, but many people find it helpful in certain situations:
- When there is significant anxiety before surgery.
- When the procedure is complex or involves major bodily changes.
- When professional guidance is desired for integrating physical change.
- When seeking a clearer understanding of what to expect during recovery.
- When expectations need to be reviewed jointly to avoid misunderstandings.
- When there is no close emotional support network available throughout the process.
It is not a resource reserved only for those experiencing difficulties, but rather another form of healthcare support.
IM GENDER: Respectful Support
The surgical process in gender affirmation is a significant stage in the journey of some trans people. It is a complex experience both physically and emotionally. At the IM GENDER Gender Unit, we understand that this process may require professional emotional support. However, this psychological support must be optional—never mandatory—professional and respectful, coordinated with the surgical team and patient care staff, and focused on the emotional well-being of the trans person undergoing surgery.
At IM GENDER, psychological support in trans surgery is an option for your well-being. If you would like more information about this service, please do not hesitate to contact us.
