Day of surgery

What to expect at GSPBC

We have provided a general description of the process at the Gender Surgery Program B.C. This information is to help you start imagining what the hospital experience could be like — you will be given more detailed and up-to-date information once you meet the GSPBC surgical team and receive your Enhanced Recovery After Surgery (ERAS) workbook:

• Enhanced Recovery After Surgery for Vaginoplasty
• Enhanced Recovery After Surgery for Vulvoplasty

Before you arrive

The GSPBC nurse and social worker will provide you with instructions on any preparations you need to do before your surgery. The day before surgery, a nurse from the hospital’s Admitting Department will call to confirm the time of your surgery and the time you need to arrive at the hospital.

Follow the instructions from your surgeon for when to stop eating and drinking the night before surgery.

Checking in

When you check in at the hospital, you’ll get a wristband with the name and gender that is listed on your BC Services Card A BC Services Card is government-issued ID. You can use it as photo ID to verify your identity or age. If you're enrolled in MSP, it provides access to health services. It can be combined with your driver's license. .

Note: The team at GSPBC will work with other hospital departments to ensure that your correct name and pronoun are used during your hospital stay. Hospital admission staff will write your preferred name on your wristband ID.

Once you’re checked in

You’ll be taken to either a room or a curtained area with a hospital bed where a nurse will share next steps with you. They’ll give you a hospital gown to change into, a basket to hold your belongings and possibly some medication. You will be given some privacy to change into a hospital gown. The surgeon may visit you and make some drawings on your body to guide the procedure.

The nurse may start an IV and check your blood pressure and assist you into the hospital bed.

The anesthesiologist may visit you to talk about the anesthetic and answer questions.

Going to the operating room

When it’s time for your surgery to begin, the nurses will help you onto the surgical table, put on a blood pressure cuff and attach some monitors. The operating room team will ask you to confirm the name of the procedure you are receiving and the name on your BC Services Card (if different). The anesthesiologist will talk you through the process of going under anesthesia.

Once the anesthesia has put you to sleep, the surgeon will begin the procedure.  Your friends and family can wait for you in the waiting room.

Immediately after the surgery

Once the surgery is finished, you’ll be taken to a recovery area, where nurses will monitor you closely until the anesthesia wears off.

You will be taken back to your hospital room and the nurses will help you get settled. They will continue to monitor you, help you with pain management and talk to you about your bandages and drains Thin tubes placed in the body during surgery to remove excess fluid or blood. . You may need help to get out of bed and walk around or go to the washroom. Make sure to ask the nurses for help.

Once you are settled, your friends and family can visit you.

After your surgery, you will stay in the hospital for 6–7 days if you have had vaginoplasty A gender-affirming genital surgery to create a vulva (including mons, labia, clitoris and urethral opening) and vagina. and 3–5 days if you have had vulvoplasty A gender-affirming genital surgery to create a vulva (including mons, labia, clitoris and urethral opening) and remove the penis, scrotum and testes. Vulvoplasty creates the external aspects of a vulva without creation of a vaginal canal. . When you are cleared to leave the hospital, you will then be discharged home or to your local temporary accommodations.

Getting home after the surgery

After surgery, you won’t be able to drive so you’ll need someone 18 years or older to escort you back to your home or accommodations. You’ll also need someone to supervise you for 24 hours following surgery. 

If you do not have someone to escort you after surgery, Hospital Transfers may be a good option to help you get home or to your accommodation. 

What to expect at GrS Montreal

Below is a description of what generally happens when you arrive in Montreal.

Before you arrive

• Have an in-person consult with your surgeon 1–2 days before your surgery.
• Follow the instructions for the night before your surgery related to enemas, showering, hair removal and removing make-up and jewelry. 
• Follow the instructions from your surgeon for when to stop eating and drinking.

Checking in

• You may be instructed to arrive at GrS Montreal’s surgical centre (called the CMC) on the day of your surgery or the night before.
• Check in with the Admissions Desk. Get a wristband with your name, date of birth, PHN and the gender that is listed on your BC Services Card. If this is different from the name you use and your gender, you can ask for an extra “Name Alert” wristband with your correct name and pronouns.

Once you’re checked in

• The staff will show you to your room. There will be a locker to store your valuables.
• A nurse will talk with you about what to expect. You’ll be given a hospital gown to change into. You’ll be reminded to remove your jewelry and nail polish. You can ask any questions you have.
• The nurse will start an IV and check your blood pressure.
• The surgeon may make some drawings on your skin to guide the procedure. 
• The anesthesiologist may visit you to talk about the anesthetic and answer questions.

Going to the operating room

• You will be taken to the operating room in your hospital bed.
• The nurses will assist you onto the surgical table and put on a blood pressure cuff and some monitors.
• The anesthesiologist will talk you through going under anesthesia.
• Once the anesthesia has made you fall asleep, the surgeon will begin the procedure. The procedure usually takes about two hours.

Immediately after the surgery

• When the surgery is over, you will be taken to a recovery area.
• Nurses will monitor you closely until the anesthesia wears off.
• You will be taken back to your hospital room and the nurses will help you get settled. They will continue to monitor you, help you with pain management and talk to you about your bandages and drains.
• On the evening after your surgery, the nurses will help you begin gentle activity by encouraging and helping you to stand upright. The next day, they will help you walk around a small amount. This improves blood flow and the speed of healing.
• You will spend the first 2–3 after surgery at GrS Montreal’s surgical centre (called the CMC).
• You will then move to GrS Montreal’s postoperative centre called the Asclépiade for about one week. This building is next door to the clinic, and a nurse will usually bring you over in a wheelchair. Nurses are on-site to provide 24-hour postoperative care, support and education.