Gender Affirmations FAQs

We will require medical clearance from your primary care provider within thirty days of your scheduled surgery. In general, this entails basic bloodwork, an EKG and a history and physical exam from your primary care provider. In addition, COVID testing may be necessary. Depending on any significant comorbidities that you may have, we may require clearance from a medical specialist.

We follow WPATH’s (World Professional Association for Transgender Health) guidelines for gender-affirming surgery.

• ONE letter is required from a mental health provider for top surgeries
• TWO letters are required from two separate mental health providers for all bottom surgeries
• Mental health providers with a Master’s degree or above must provide the letters.
• Letters must be dated within twelve months of the consult/surgery

We ask that you have these letters ready prior to booking your consultation.

Our highly-trained office staff will work very diligently to try to get your surgery covered by insurance. We are Out-Of-Network with all insurances, however, we will work directly with our insurance to try to obtain coverage. Our team advocates for you as the patient throughout the process. If your insurance does not cover the procedure, we will provide you with an out-of-pocket quote.

Yes! We understand that there is a major lack of skilled, board-certified and fellowship-trained gender-affirming surgeons in this country. We have patients that come from all over the country to see Dr. Keith. If you are not local to the New Jersey area, please let our team know when scheduling your appointment. Oftentimes, your first visit can be done via telehealth. In addition, we can help guide you as far as hotel or AirBnB stays for after surgery, if needed.

As providers of your gender-affirming care, we never want our patients to feel excluded from care based on their weight. In general, there are no BMI requirements for top surgery. Depending on the type of bottom surgery that you choose, there may be a BMI requirement based on use of certain tools, like the da Vinci® robot, or a BMI requirement for general anesthesia based on how long your surgery will take. If weight loss is required prior to surgery, we can refer you to a nutritionist or a bariatric surgeon, depending on the specific situation. Our goal is to provide surgical care in the safest manner possible.

We do use drains for many top and bottom surgeries. Drains are a very important part of preventing seroma formation and clearing your body of excess fluid. Drains are very temporary and our office will guide you on how to take care of them.