SURGERY (COSMETIC & CONFORMING) There are many competent surgeons internationally who are skilled in performing the operations one might desire to improve their appearance or become more gender functional. Dr. Horowitz will help you choose a surgeon who best meets your needs, both for cosmetic surgeries and for the different gender conforming surgeries. In addition, Dr. Horowitz will provide letters of referral for surgery and insure a careful and thorough pre-operative examination. He will then communicate directly with the surgeon to insure excellent continuity of care and the best possible surgical outcome. Instructions on managing hormone treatment pre and post operatively are always discussed in detail with you. After surgery one’s hormone regimen is gradually adjusted to new maintenance doses that depend in part on how advanced an individual’s transition is.