It is important that you are aware that everyone's experiences of surgery are different, and therefore your experiences may not be exactly as follows. Additionally, it is important that you have established yourself comfortably as a woman before you approach me about gender affirmation surgery. It would be wise for you to resolve either fully or mostly, any other aspects of your transition including facial hair, voice training and social adjustment. Surgery will not achieve a change of gender on its own. The outcome will be to reshape your genitalia from a male function and appearance to a female function and appearance. All male reproductive organs will be removed.

Prior to surgery you must provide two independent psychiatric evaluations that indicate clearly that this surgery is appropriate for you. One of these evaluations may alternatively be provided by a clinical psychologist. I will require a letter from your endocrinologist or the doctor who has provided you with hormones, stating that you have undergone adequate hormonal reassignment from male to female. Additionally you will need to provide recent HIV and Hepatitis B results. Please note that if these reports indicate that you carry either of these viruses, you will not be excluded from surgery provided that your physician indicates that the surgery is not likely to adversely affect your health.

The total cost of surgery including hospitalisation, anaesthetic, pathology, medication and follow-up surgical consultations required for 12 months will vary according to the type of operation that you have. Following visits to Schrang in America I am able to offer a two staged procedure, in other words two operations separated by approximately 3 months, which leads to a very convincing appearance.

If you are travelling from interstate or overseas, accommodation is available in the local area. Please contact our rooms if you would like help arranging accommodation. When considering accommodation please note that you will require salt baths following discharge from hospital.

You may make an appointment with me at any time prior to surgery to discuss the technique you will require. You may wish to discuss associated risks and outcomes and you can arrange billing of services and dates available for surgery. If you are travelling from interstate or from overseas, most arrangements can be made by phone and mail, however all patients will be required to make an appointment on the Friday before surgery.

Please note that I will make a final assessment at this consultation and the decision as to whether to perform this surgery will be made by me. At this appointment a consent will be signed, risks and outcomes of surgery will be discussed, bowel preparation, scripts and dilators organised. At this time all payments must be made in full for the surgery and anaesthetic.

Surgery will be performed at the Sydney Private Hospital in Ashfield, Sydney. You will be in hospital for 7-10 days and will remain in bed for 3-4 days. You will have an intravenous drip and a urinary catheter for 5 days. Your neovagina will be packed and sutured after the surgery. This pack will be removed on the Friday and you will then commence dilating and will have to continue a routine as instructed.

A vaginal entrance will have been constructed including labia and the vagina will provide sufficient depth for the dilators supplied. Problems can develop with the depth of the vagina following surgery and you must be satisfied that you have discussed this matter fully with me prior to surgery.

This surgery includes the formation of a neoclitoris which is fashioned from a small piece of skin from the head of the penis. The aim of the surgery is to make this area fully sensitive and most patients report being able to orgasm after surgery by manual stimulation.

Dr Haertsch also performs surgery to soften the Adams apple (tracheoplasty) and breast augmentation. While he does perform surgery to soften the brows, the does not do any facial feminisation.

You will be discharged from hospital when you are able to manage at home and an appointment will be made for you to see me the following week. If you are from overseas or interstate please try to arrange to stay for at least 2 weeks after discharge from hospital so that you can see me at my office should you have any problems.

If you have any further questions, please do not hesitate to contact my rooms.