Transgender Health and Surgical Guidelines

Transgender surgery is an option for adults who are diagnosed by a mental health care provider as having gender identity disorder. In actuality, very few transgender patients undergo sexual reassignment surgery.

The Harry Benjamin International Gender Dysphoria Association provides the following eligibility and readiness criteria for transgender adults seeking reassignment surgery:


  • Legal age of majority (age 18 in the United States)
  • 12 months of prior continuous hormone therapy (HT), unless medically contraindicated
  • 12 months of successful, continuous, full-time, real-life experience
  • Regular, responsible participation in psychotherapy, if required by the mental health professional
  • Demonstrable knowledge about surgical cost, length of hospitalization, complications, and rehabilitation
  • Knowledge of different competent surgeons


  • Patient has made demonstrable progress in consolidating gender identity.
  • Patient has made progress in improving or continuing stable mental health (implies control of sociopathy, substance abuse, psychosis, and suicidal tendencies).

Adapted from Standards of Care for Gender Identity Disorders. 2001. The Harry Benjamin International Gender Dysphoria Association.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 31 Jul 2001

Last Modified: 08 Oct 2015