Well, the hospital I am going to has a whole trans healthcare wing essentially, though they don’t call it that. It’s a subsection of the plastic surgery group, but my surgeon in particular works with lots of trans patients.

What I’ve noticed is that they make a standard practice of asking for name and pronouns, and then sharing their own. I personally don’t like this, but I get how it would help with non-binary folks or people who use neopronouns - so I tolerate it 😅 Mostly it feels stigmatizing to me, and when I work with people who know I’m trans it’s a different experience than people who don’t know I’m trans and who just see a woman. Since I just wish I were a cis woman, I prefer working with the nurses that don’t know I’m trans and thus don’t try to treat me differently (even as accommodating or being nice) based on my transness. I don’t want to be trans or treated differently for being trans.

The healthcare team was pretty responsive to my questions through the online portal, and in general seem competent.

My surgeon has awful bed-side manner, despite his excellent skills in the operating room - each time I interact with him I come away thinking he could really work on his delivery, lol - for example, when he saw me right before wheeling into the OR for my orchiectomy, he looked at my thighs and said “you need to lose 20 lbs” - it’s true losing weight can improve recovery, esp. for a vaginoplasty, but the way he put it was so direct and rude. (And tbh a bit hurtful, I struggle enough with my body and weight, and it just felt like a confirmation of my negative self image.)

Right before my surgery yesterday, the surgeon said that if the orchiectomy left a scar that makes it too difficult to him to use the scrotum as a graft, he will just do a vulvoplasty / shallow-depth vaginoplasty and then I would have to come back in 6 months to get full-depth (presumably with peritoneal pull through). For context, we specifically asked about whether the orchi he did would interfere with the vaginoplasty, and he said no - so learning it could right before being wheeled into the OR was anxiety producing since I suddenly didn’t know if I would wake up with a full-depth vaginoplasty like we had agreed on.

Other staff had trouble communicating clearly - like they would mumble or speak too quickly for me to understand what they were saying, but these are more like personality issues.

If you want to know how to work with trans patients I would just think the most important thing is to think of them as their gender - if you have a trans woman patient, just think and treat her as a woman and all is well. Ditto for trans man, and for non-binary patients it’s not that different. Knowing and respecting pronouns, and doing what you can to put in your mind that they are the gender they say they are is probably the best advice I could give.

Relatedly, there are lots of intersex people who are trans, so also not making too many assumptions could be good - sometimes anatomy will be different than you thought for a trans person, i.e. a trans woman might be intersex and not even realize they have an intersex condition which might mean they have anatomy they don’t realize they have, etc.

And when you’re working with trans patients I would say it’s important to just treat them like any other patient - when I looked very trans and wasn’t passing, I often would get this overly nice treatment that felt more like pity than respect or support.

Let me know if you have specific questions I didn’t cover!