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Transgender Surgery Eligibility, Referral, and Readiness Process

Eligibility and Referral Process

PDF version of the Eligibility and Referral Process chart -
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THS Process Flowchart

Criteria for Surgery Referrals

Required Documents for Surgery Referrals

  1. E-Referral in LCR or for providers who don't have LCR, Surgery Referral Patient Summary Sheet
  2. Medical Evaluation
  3. Therapist Documentation Form for Evaluation for Transgender Surgery to be completed by 2 licensed mental health providers for genital surgeries, or 1 licensed mental health provider for chest surgeries. Learn more about the Guidelines for Psychosocial Assessments. Read the Executive Summary of the Guidelines.
  4. Patient Education Documentation:



Patient Readiness for Surgery

Education and Preparation Program

Transgender Health Services will work with all patients to provide a comprehensive education and preparation program (EPP) to ensure good outcomes. Completion of this program is required before surgery and varies in length and format depending on the specific surgery that the patient will be undergoing. Providers should notify Transgender Health Services of their patient’s surgery date so that we can plan a timeline for completing the EPP in advance to ensure the best outcomes possible for surgery.

Surgery Preparation and Aftercare Instructions for Patients

Dr. Crane Pre-surgery Bowel Preparation
Dr. Crane Aftercare Instructions for Vaginoplasty
Dr. Bowers Aftercare Instructions for Vaginoplasty
San Francisco General Hospital Chest Reconstruction Surgery Instructions

Budgeting and Supply Lists

Vaginoplasty with Dr. Bowers
Vaginoplasty with Dr. Crane
Masculinizing Chest Surgery at San Francisco General Hospital


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Transgender Health Services
San Francisco Department of Public Health
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