The Role of Mental Health in Gender Surgery

Your mental health in gender surgery is important to being as prepared as possible for the stressors you will face. 

We all have low moments throughout our lives, mainly due to external stressors. The nature of our most depressed times is best explained through our own ways of managing them.

Here we are referring to extreme emotional difficulty: when anxiety is through the roof, we are constantly nervous and agitated, or we feel so sad that there is barely strength to continue. In the worst of cases, we may even think that maybe life is not worth it.

We could ask ourselves, “Is FFS right for me now?”

When poor mental health in gender surgery is a problem

In these cases in which our negative emotions consume us, we recommend you do not start a surgery process until in a better controlled state of mind. By this, we do not mean that people who suffer anxiety or depression cannot have surgery. They can, as long as the situation is being managed. In some cases, this may require medication or professional help. 

Am I ready mentally to undergo gender surgery?

Imagine the ideal level of mental health in gender surgery. Feelings of safety, trust, peace, relaxation and confidence are words that may come to mind. However, when we are in our worst emotional state, it is not a good idea to face too many major stress triggers. Facial gender surgery is one more stressful factor. When added to those already present in your life, this creates the perfect conditions for nervousness or an emotional explosion at any moment.

To explain, let’s identify the main stressors that exist around any surgical event: 

Stress while planning gender surgery

Facial gender-affirming surgery is highly desired by patients, who often feel an urgency to do everything to transition. Waiting for the day can be stressful, especially when delays happen. Despite the surgery being something you truly want to improve your life, at the same time, having planning to have surgery itself is inevitably stressful.

By stressful we mean that there are many things to organize prior to surgery. You may be fretting about the million details to sort when traveling far from home, planning finances, time off work, who will look after the house and pets, etc. You will have stress from the prospect of going it alone. Or imagining what it will be like travelling with someone you have a complicated relationship with. 

Stress due to the surgical operation

In addition, it is obvious that the surgery itself is a stressful event on a physical level.  The body is subject to a controlled “trauma” to it’s tissues after which it must regenerate. The healing response takes a lot of energy from our metabolisms, making it function at a higher than normal range–which is a type of stress on our system. The postoperative period requires specific palliative care, as there is usually discomfort due to the intervention. 

In short, the surgery itself is stressful and puts you in a vulnerable position. If you are not in a good emotional state, it is more probable that it will be overwhelming. It certainly will be more difficult to handle compared to other patients whose feelings are balanced.  We talk more about emotions when facing surgery in this mental health series.

The expectation vacuum & expectations in check

The surgical day has passed and now you are left with a feeling of emptiness after so long desperately waiting for this event. It’s done, so now what? This “expectation vacuum” can leave you feeling more disoriented than usual, something we spoke of in the 3rd article of this series on postoperative depression. 

Another important aspect related to emotions is expectations. Realistic expectations are essential to keeping your emotions in balance. When we are going through bad times, we tend to hope that surgery will magically help us to improve our lives on all levels, not just the physical. However, it is not rational to attribute this power to fix everything that is wrong in your life to surgeries. In cases where we are very depressed or anxious, it’s even harder to face this realization.

Facial gender-affirming surgery harmonizes the facial features to bring them more into feminine parameters. However, it cannot do much more for your emotions than you permit it to, such as feeling better about yourself and who you see in the mirror. If you suffered serious depression beforehand, surgery alone will not improve this.

Caring for your mental health in gender surgery

So, we always recommend that if you are going through a bad time, before ruling out surgery, ask for help. Surely going to therapy or join a transgender support group can help you to see things differently, to learn to manage your emotions and the simple act of caring for your mental health in gender surgery will probably begin to improve your mood.

This will help you to feel stronger and better prepared for the stress that comes with having a surgical intervention of this caliber. By putting your mental health as a priority, you are more likely to be able to handle facial feminization surgery in a serene, conscious way.  Above all, it may even enable you to enjoy the process despite the discomfort.

Please check the rest of our Mental Health series!  Also, check our Youtube channel playlist of videos on relaxation to help redirect your mind during those low moments when you need a positive reset!

Patient Relations Manager Lilia Koss, presentator of Lilia's Livestreams
About the author

Hello world! I’m Lilia Koss and I use she, her, and they pronouns. What are yours? With a background in humanities and diverse professional experiences, I have been working with the Facialteam founders and directors since 2008. Involved from the ground up, so I’ve had hands in many pots: patient coordination, orientation events on 3 continents, social media, written and audiovisual content about our gender-affirming healthcare...but now life is more defined. Lately, I focus my energies on Public Relations, community management and live streaming to help raise the visibility of trans health. Life is pretty complete.