Our Surgery Protocols

General

As a general rule, we tend only to schedule patients for surgery where they require sufficient surgical procedures to warrant a full hospital operation under general anesthetic. This may be either SRS, a full FFS surgery, or by combining minor FFS procedures (decided on a patient-by-patient basis) at the same time as the patient is undertaking SRS and/or AM. Because of the time that would be needed under general anesthetic and consequent risk to the patient Dr Suporn will not perform full FFS on a patient in the same operation as SRS. In this context, “full FFS” means undertaking more than one of the 4 main group surgical packages outlined under “ffs procedures“.

For a guideline to the time required for the surgery, and the recovery time spent in hospital please see our scheduling table

Due to the long duration under which patients are under general anesthesia, all patients are advised to have a full medical check-up to confirm that they are physically fit, of healthy weight, and are strong enough to be under general anesthesia for a period upwards of about 5-1/2 hours for SRS. In our experience, Dr Suporn’s patients require about twice the duration of total recovery period (3 to 4 months) compared with having SRS elsewhere. All SRS patients must stay at least 24 days and preferably 30 days in Thailand to ensure proper recovery under the care of the Clinic staff.

Requesting an Operation

We will not consider any application to undergo an operation, before a client has completed and returned a Client profile, which provides us with personal, medical and surgical history, from which we can assess their eligibility to undergo the surgical operation of their choice.

It is a .pdf fillable form, and covers important questions leading up to possible surgery. Please download it from our web site here

Unzip the contents to a suitable place on your hard drive. Browse to that location.

You will find it contains 2 documents. One is a guide to completing it, which you should read first. It contains instructions on how to open the document to complete it. If you follow those instructions, completion is very easy; if you ignore the instructions, it can be quite difficult to open the document.

Once open It can be completed easily in a few minutes by using the free Adobe Acrobat Reader or Acrobat Pro, versions 8 or later, which run on Windows or Mac OS. Please note that it does not run on iOS (iPad or iPhone) or Android. If you do not have Adobe Acrobat, the free reader can be downloaded from Adobe here

Please be sure to answer every question completely and accurately. We need to know your entire medical and surgical history – including any planned operations that have not yet been done. We are not able to accept a reservation for surgery without this information being completed.

Once you have completed it, please send it back to us at admin@supornclinic as an email attachment.

Minimum Psychosocial requirements for Patients Scheduling SRS

It is not Dr. Suporn’s policy to deny SRS surgery to any patient he believes to be medically and psychologically fit to undergo it. As far as is considered reasonable, The Suporn Clinic follows the guidelines of the World Professional Association for Transgender Health   (WPATH). Additionally, we always comply with the Medical standards of Thailand. We require patients to provide written evidence that they meet the following criteria:

SRS Under Age 20

Under Thai medical regulations, patients under the age of 20 are unable to undergo surgery without the written approval of their parents, legal guardians, a direct blood relative, or an individual who has legal Power of Attorney over your affairs. The signee must, himself or herself, be aged over 20. The signed document giving approval for you to undergo SRS must also be accompanied by an originally signed photocopy of a photo-ID which bears the same signature. If the family name of the signee is different from your own family name, copies of suitable evidence must be given to link the signee with having the authority to sign on your behalf.

If you are able to obtain this approval, Dr Suporn would be quite happy to proceed with surgery – providing you are able to meet the other criteria of our protocol, particularly in respect of having been diagnosed gender dysphoric, and having psychotherapeutic agreement to undergo the surgery. If you do not provide this approval, in original format, at the time of the operation, Dr Suporn will not proceed.

Dr Suporn is unable to undertake SRS on patients aged less than 18 years.

Patients Aged 65 and over

Dr Suporn no longer accepts patients aged 65 and over for SRS or substantial FFS operations. To amplify the meaning of “substantial”, please contact the Clinic to discuss specific circumstances.

Pre-Operative Medical Requirements and Surgical Considerations

Patients will only be operated on if they are medically fit for surgery. While a full medical check-up is provided at the hospital prior to surgery, all patients with known medical conditions are strongly advised to undergo a full medical check-up by their own medical practitioner prior to confirming their surgery booking. They should obtain and submit along with other documentation a report from their medical practitioner certifying that detailing date of birth, height, weight, medical history, medical conditions, and a recommendation that the patient is physically fit to undergo major surgery under general anesthesia.

All patients are screened with an electronic questionnaire prior to scheduling for surgery.

Final medical clearance for surgery depends on satisfactory results of the medical admission tests, and consent of the anesthesiologist at Aikchol hospital

Orchiectomy

Bilateral orchiectomy is not recommended prior to SRS, but is permitted. If the scrotal sac has been removed, the applicant must seek elsewhere to undergo SRS.

Genital Electrolysis

Prior genital electrolysis is not required. Permanent genital depilation is unnecessary,  expensive and uncomfortable. All hair follicles are manually excised (cut) from the scrotal skin during surgery, and will not grow subsequently. A hair-free vaginal lining is guaranteed. Prior electrolysis of the scrotal area may result in scarring and thickening of the skin which could reduce its elasticity and vaginal depth. If desired, only the perineal region (perineum) between the anus to the scrotum should be cleared (which can also be cleared after SRS)

Blood Transfusions

For all surgery, no blood transfusions are used (no need for patients to bring their own blood supply)

Deep Vein Thrombosis (DVT) Risk Avoidance

Major surgery – particularly SRS – carries the potential risk of incurring Deep Vein Thrombosis. Dr Suporn and his team take every precaution possible to minimize the risk of DVT. However, much of the responsibility for risk avoidance of DVT rests with the patient, not with the surgeon. Patients are recommended to reduce weight to acceptable (non-obese) levels, to remain actively fit, and to take adequate exercise during any long-haul flight. In addition:

  • Hormones. All anti androgen/hormone injections must be stopped 4 weeks before traveling, and anti androgen/hormone oral tablets, gels, patches, and aspirin must be stopped 1 week before traveling to Thailand
  • Smoking and any heavy drinking must be stopped at least 1 month before traveling to Thailand.
  • Patients who fail to stop taking hormones or/and smoking before surgery will have their surgery cancelled.

Patients who smoke must make every effort not to resume until at least one month after surgery. FFS patients – in particular – should be aware of the extreme adverse effect that smoking has on post-operative recovery and results.

After surgery, hormone treatment can be resumed 2 weeks after surgery (in the case of SRS resumption of anti androgens is not necessary unless prescribed to the contrary by your medical practitioner)

HIV

Dr Suporn does not undertake elective surgery on HIV+ (positive) patients. Patients who have any doubts about being HIV- (negative) should have the test before coming to Thailand. Patients who fail to disclose any serious medical conditions, including clinical obesity, may have their surgery cancelled upon arrival to Thailand, and forfeit all payments made for surgery.