Center for Gender Surgery | Eligibility for Surgery

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.

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.