About the Program
Specialists in the Transgender Health Program and Transgender Surgical Program at Massachusetts General Hospital are dedicated to ensuring a welcoming and affirming environment for all patients. We offer patients a wide spectrum of gender-affirming services to support them throughout their entire care journey, including comprehensive primary care, surgical treatment, hormone management, case management and behavioral health support.
The Transgender Surgical Program is a collaboration with specialists from the Mass General Division of Plastic and Reconstructive Surgery, the Department of Urology and the Department of Obstetrics and Gynecology. Our multidisciplinary surgical team works closely with providers from the Transgender Health Program and every patient to develop a safe and all-inclusive surgical plan that aligns with the patient’s personal goals.
What to Expect
About the Initial Consultation
If you are interested in undergoing gender-affirmation surgery at Mass General, you will first meet with a general provider from the Transgender Health Program. To the visit, please bring:
- Copies of medical records, including testing results and notes from other specialists
- Letters of support such as referral letters from mental health professionals and primary care providers and insurance authorization. The Mass General Transgender Surgical Program team can provide guide patients through the process of obtaining these letters
- List and dosages of current medications, vitamins and herbal supplements
During this initial visit, your doctor will review all of the above documentation and answer your questions. They will ask for your preferred pronouns to note in the chart and use throughout the process. To schedule an appointment, call 617-643-7210 or send an email to MGHTransHealth@mgh.harvard.edu.
Note: You are not required to schedule an intake visit with the Transgender Health Program if you plan to pursue top surgery (mastectomy or breast augmentation) unless you need a referral for support services. Instead, please feel free to contact the Transgender Surgery Program team at 617-643-7210 to ensure that your letters of support are in place and receive instruction on how to proceed with a surgical consult.
About the Surgical Consult
Once the Transgender Health Program has confirmed that you are ready for a surgical consult, we will reach out to you to schedule it. During this 30-60–minute consultation, you will meet with specialists from plastic and reconstructive surgery, urology and gynecology to review your treatment goals and develop a safe and personalized surgical plan.
Surgical Procedures
Our expert team performs a variety of gender-affirming surgical procedures for transgender and gender-nonconforming patients.
Vaginoplasty
Vaginoplasty is surgery to create the vulva (clitoris, labia majora, labia minora). It includes orchiectomy, or surgery to remove the testicles and penectomy, or removal of the erectile tissue and shortening of the urethra. Depending on your goals, your surgical team can also create a vaginal canal.
Patients who undergo vaginoplasty at Mass General must:
- Complete a pre-surgical consultation with the Transgender Health Program
- Be at least 18 years of age at the time of surgery
- Have received at least 12 months of affirming hormone treatment
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Not smoke or vape (cigarettes, marijuana, or other substances) or have any nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery
- Complete appropriate hair removal (laser or electrolysis) before surgery. We can provide a list of trans-affirming hair removal providers
- Consult with a Mass General fertility specialist and complete gamete preservation before surgery, if that is of interest
- Obtain two letters of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): Full-Depth Vaginoplasty (with vaginal canal)
Welcome Packet (PDF): Zero-Depth Vaginoplasty (without vaginal canal)
Orchiectomy
Orchiectomy is surgery to remove the testicles.
Patients who undergo orchiectomy at Mass General must:
- Be at least 18 years of age at the time of surgery
- Have received at least 12 months of affirming hormone treatment
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Not smoke or vape (cigarettes, marijuana, or other substances) or have any nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery
- Consult with a Mass General fertility specialist and complete gamete preservation before surgery, if that is of interest
- Obtain one letter of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): Orchiectomy
Hysterectomy
Hysterectomy is surgery to remove the uterus, cervix, and my also include the removal of the fallopian tubes and ovaries (if desired, one ovary can be preserved).
Patients who undergo hysterectomy at Mass General must:
- Be at least 18 years of age at the time of surgery
- Have received at least 12 months of affirming hormone treatment
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Consult with a Mass General fertility specialist and complete gamete preservation before surgery, if that is of interest
- Obtain two letters of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): Hysterectomy
Phalloplasty
Phalloplasty is surgery to create the penis. It is a multi-staged operation that can include a variety of different procedures, depending on your goals. For example, in some cases, surgeons will first perform a hysterectomy.
At Mass General, our expert team can utilize various tissues to create a phallus depending on your medical history, age and body habitus, including:
- Abdominal phalloplasty—surgical construction of a penis using tissue taken from your abdomen
- Radial forearm flap—surgical construction of a penis using tissue taken from your arm
- Anterolateral thigh flap—surgical construction of a penis using tissue taken from your leg
- Musculocutaneous latissimus dorsi flap—surgical construction of a penis using tissue taken from your side
Your care team will discuss these options with you and offer their recommendations.
Patients who undergo phalloplasty at Mass General must:
- Complete a pre-surgical consultation with the Transgender Health Program
- Be at least 18 years of age at the time of surgery
- Have received at least 12 months of affirming hormone treatment
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Not smoke or vape (cigarettes, marijuana, or other substances) or have any nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery
- Complete appropriate hair removal (laser or electrolysis) before surgery. We can provide a list of trans-affirming hair removal providers
- Consult with a Mass General fertility specialist and complete gamete preservation before surgery, if that is of interest
- Obtain two letters of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): Phalloplasty
Mastectomy
Mastectomy is a surgery to remove breast tissue sometimes referred to as top surgery. If desired, our team can also contour a more masculine chest as part of the procedure.
Patients who undergo mastectomy at Mass General must:
- Be at least 18 years of age at the time of surgery
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Not smoke or vape (cigarettes, marijuana, or other substances) or have any nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery
- Obtain one letter of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): Mastectomy
Breast Augmentation
Breast augmentation is surgery to place silicone or saline implants under breast tissue or chest muscles to create larger breasts.
Patients who undergo breast augmentation at Mass General must:
- Be at least 18 years of age at the time of surgery
- Have received at least 12 months of affirming hormone treatment
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Not smoke or vape (cigarettes, marijuana, or other substances) or have any nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery
- Obtain one letter of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): Breast Augmentation
Facial Feminization or Masculinization
Facial feminization is surgery to alter facial features—the chin, nose, cheeks, forehead, etc.—to create a more feminine or masculine facial structure.
Patients who undergo facial feminization (FFS) or masculinization (FMS) at Mass General must:
- Complete a pre-surgical consultation with the Transgender Health Program
- Be at least 18 years of age at the time of surgery
- Have received at least 12 months of affirming hormone treatment
- Have a BMI of less than 35 (due to the risk of flap loss in individuals with higher BMI)
- Not smoke or vape (cigarettes, marijuana, or other substances) or have any nicotine exposure for 60 days before surgery and cannot smoke, vape or use any other nicotine products for six weeks after the surgery
- Complete appropriate hair removal (laser or electrolysis) before surgery. We can provide a list of trans-affirming hair removal providers
- Obtain one letter of referral from a licensed mental health professional dating from the past 12 months (one must be from a psychotherapist, and one can be from an evaluative mental health professional)
Welcome Packet (PDF): FFS
Welcome Packet (PDF): FMS
Vocal Procedures
Voice feminization surgery lengthens the vocal cords to change the voice to a higher pitch. Vocal coaching with a speech and language pathologist is required before surgical intervention.
Voice masculinization surgery can include increasing or decreasing the vocal cords’ tension and/or speech therapy. This procedure is far less common as 75% of people can masculinize their voice with hormone therapy.
To request an appointment with the Mass General Voice Center, please call 617-726-0218 or email Voice_Center_2@partners.org.
The duration of your hospital stay following surgery will depend on the procedure. In general, you can expect to stay between one to five days at the hospital following surgery for rest and recovery. If your procedure is deemed an outpatient procedure, you can expect to return home on the same day as surgery.
Frequently Asked Questions
How do I schedule an appointment?
For genital or “bottom” surgery, the first step is to schedule an initial visit with the Transgender Health Program. To schedule this appointment, call 617-643-7210 or send an email at MGHTransHealth@mgh.harvard.edu. For breast or “top” surgery, you are not required to schedule an intake visit with the Transgender Health Program, unless you need a referral for support services. Instead, please contact the Transgender Surgery Program team at 617-643-7210 to learn how to proceed with a surgical consult. Providers should fax referrals to 617-724-7126.
Following confirmation from the Transgender Health Program that you are ready to move forward with bottom surgery, the Transgender Surgery Program team will contact you to set up a surgical consult.
What is the average timeline between initial consult and surgical consult, and then between surgical consult and surgery?
The average time between initial consult and surgical consult is dependent on the procedure and can vary, but is on average between two to three months. The average time between the surgical consult and surgery varies widely based on the procedure and other contributing factors (e.g., hair removal), but is on average between two to three months. The care team is always available for questions, and patients are encouraged to ask questions at any time.
What are the options to preserve my fertility when undergoing gender-affirming surgery?
Fertility preservation offers the opportunity to freeze eggs or sperm to be used for building a family in the future. This can be done prior to initiation of gender affirming hormone therapy or surgery. For some, it can also be used after hormonal therapy has already been started. Resources and care are also available for coordinating use of eggs or sperm from another person (donor) or for another individual to carry a pregnancy (gestational carrier).
Patients who desire fertility preservation or family building through Mass General must:
- Complete a consultation with the Mass General Fertility Center
- Be of reproductive age (requirements vary by family building plan)
- Follow center-specific guidance and protocols for selected treatment
During your surgical consultation, your physician will ask you about your fertility preservation goals and will assist you with setting up a consultation with a fertility specialist. We are committed to supporting you and guiding you through this process.
What documentation do I need before surgery?
Required documents prior to surgery vary depending on the type of procedure. Our surgical program coordinator will assist you with questions and provide you with more information during your surgical consult.
How do patients obtain insurance authorization?
Once we’ve scheduled a surgical date, we will submit a prior authorization for surgery to your insurance company for approval. Some out-of-network insurances may require you to obtain prior authorization for surgical consultations. Please reach out to your insurance company to determine what is required. Our dedicated surgical coordinator is happy to assist you with this process.
Does Mass General have an affiliation with hotels that offer medical rates?
There are medical rates at many of the surrounding local hospitals. Depending on the procedure, you may need to remain local for a few weeks. If you are interested in medical rates, our dedicated surgical coordinator will be happy to provide you with more information.
Meet Our Team
The Mass General Transgender Surgical Program and the Transgender Health Program form a multidisciplinary and collaborative team of providers and staff who work together to provide gender-affirming care for all patients.
Plastic and Reconstructive Surgery

Role: Chief, Division of Plastic and Reconstructive Surgery
Specialty: Mastectomy
Pronouns: He/him/his

Role: Surgeon
Specialty: Facial feminization and masculinization
Pronouns: He/him/his

Role: Surgeon
Specialty: Phalloplasty
Pronouns: He/him/his

Role: Surgeon
Specialty: Top surgery
Pronouns: He/him/his

Role: Surgeon
Specialty: Vaginoplasty, breast augmentation and mastectomy
Pronouns: He/him/his
Obstetrics & Gynecology

Role: Gynecologic Surgeon
Specialty: Vaginoplasty, vaginectomy and hysterectomy
Pronouns: She/her/hers
Urology

Role: Urologist
Specialty: Phalloplasty, orchiectomy and vaginoplasty
Pronouns: He/him/his
Transgender Health Program

Role: Medical Director, Transgender Health Program and Adult Medicine
Pronouns: He/him/his

Role: Adult, Pediatric and Adolescent Medicine Physician
Pronouns: She/her/hers

Role: Adult Medicine Physician
Pronouns: She/her/hers
Clinic Staff

Leah, RN
Role: Dedicated Gender-Affirming Surgery Program Surgical Nurse
Pronouns: She/her/hers

Candace Nguyen
Role: Surgical Program Coordinator
Pronouns: She/her/hers

Heather Parker, NP
Role: Plastics and Reconstructive Surgical Nurse
Pronouns: She/her/hers