Hanna Gender Center

Frequently Asked Questions

From my staff and I, congratulations on making it this far in your transition journey.

We understand that you likely have questions and concerns at this stage – many of our patients do.

If your question is not addressed on this page, please do not hesitate to reach out. Alternatively, we can discuss your specific concerns during your consultation.

I am dedicated to serving the transgender and non-binary (TGNB) community through gender-affirming surgery procedures. I am one of the few surgeons in the United States with this focus.

My training is extensive. I traveled to Europe to learn advanced techniques under distinguished professor and leader in urogenital reconstructive surgery, Dr. Miroslav Djordjevic. I then completed a gender-affirming surgery fellowship in the Philadelphia area.

The Hanna Gender Center staff and I offer more than expertise. We are compassionate listeners who take an individualized, patient-centered approach to everything we do. We are understanding and considerate, and your comfort, care, and experience are our top priorities.

Yes. We offer video consultations. Although we love to meet our patients face-to-face, we recognize that travel may be difficult. Many of our patients have busy schedules or live outside of the Dallas/Fort Worth area.

We use a video conference system that does not require you to install software on your computer for your peace of mind.

Yes, there are several things you will need to do prior to having surgery. Requirements vary depending on the type of case: Top Surgery
  • ONE referral letter from mental health professional
  • It is recommended but NOT REQUIRED to be on hormones for a period of 12 months.
Breast Augmentation
  • ONE referral letter from mental health professional
  • Hormones for minimum 12 months, unless contraindicated medically or personally unwilling to take (please note that this will need to be well documented for insurance purposes). In addition to reducing dysphoric episodes, hormone therapy can cause a natural increase in size of natural breast tissue, and potentially improve operative outcomes.
  • Must be 22 years old or older
Bottom Surgery (Genital Surgery)
  • TWO referral letters from separate mental health professionals
  • Hormones for minimum 12 months (This should be appropriate to your gender goals. If you have a medical contraindication or are otherwise unable or unwilling to take hormones, then ok to not be on hormones. Again, this will usually need to be well documented)
  • 12 continuous months of living in a gender role that is congruent with their gender identity
  • Mental health/medical health concerns must be reasonably well controlled
  • Persistent, and well documented dysphoria
  • 18 years old

Prior to surgery, we will have you obtain routine blood and urine tests. Depending on your age and health, we will sometimes order an EKG and/or chest x-ray. You will need to obtain a physical exam by your primary care physician no more than 30 days before surgery.

1) Tobacco use is the enemy of great outcomes. If you are still smoking, you will need to stop using all tobacco products including marijuana and vaping at least 1 month prior to, and ideally lifelong after surgery. Certain byproducts of the combustion process involved in smoking, as well as nicotine in vaping may prevent you from having the best outcome possible.

2) Chronic medical conditions such diabetes, AIDS, steroid use and others will need to be addressed prior to surgery.

3) You have come this far and want to look perfect immediately after surgery. Understand that this will take time and does not occur right immediately after you leave the operating room. It takes time for skin edges to heal together, for inflammation to resolve, and new tissue to settle in place. We will work together to get you to your ideal outcome as fast as reasonably possible.

4) You should maintain routine hygiene practices, and adhere to post-operative guidelines for the best possible result.

Yes! We work with many different specialties to help you get to where you want to be. These specialties include: microsurgery, ob/gyn, psychiatry, and endocrinology.

No. We do not require you to undergo painful and expensive electrolysis or laser hair removal before surgery. Instead, during your procedure, I will remove the necessary hair while you are under anesthesia.

Yes. This can occur. However, it’s highly unlikely. If hair regrows, the follicles are typically lighter in color, less abrasive, and fewer in number than previously.

If you experience hair regrowth, we are more than happy to ensure permanent removal using a fast and painless method in our office.

Yes, and yes! The clitoris is formed using existing genital tissue, so your erotic nerves are preserved. During penetrative intercourse, expect a pressure-like sensation. Orgasm will require sexual and physical stimulation, just as it did pre-surgery.

Yes. It’s your body, and you have control over your impants.. Before your surgery, I will work closely with you to identify the most appropriately sized implants for your body and wishes.

While you are the authority, I will offer some guidance based on my training and experience:

  • For breast implants, we generally recommend silicone. These offer the most natural look and feel.
  • For testicular implants, you will decide and sign off on your preferred sizes preoperatively. You will select a range of options you are comfortable with, and, depending on several factors, I will make the final discretion in the operating room.

I will never give you an implant size you did not sign off on before surgery.