American Urological Association - Genital Gender Affirming Surgery for the Transgender Patient: A Didactic and Hands-On Cadaver-Based Course


Home Education AUAUniversity Live Events Educational Calendar Genital Gender Affirming Surgery for the Transgender Patient

Genital Gender Affirming Surgery for the Transgender Patient: A Didactic and Hands-On Cadaver-Based Course

Maximum of 7.00 AMA PRA Category 1 Credits™AUA 2018 event

Course Location

University of California, San Francisco
San Francisco, CA

Live Course

May 17, 2018
At the University of California, San Francisco (UCSF) School of Medicine
Starting at $1435
Space is limited, so register early!
The AUA recommends that you register for the course BEFORE making travel arrangements. Once the meeting capacity is reached, which may be prior to the early-bird date, the AUA is unable to guarantee a spot in the course.

Target Audience

General urologists and reconstructive surgeons interested or already performing genital gender affirming surgeries.

Course Description

This is a one-day course comprised of didactic lectures and two 2-hour hands-on fresh-cadaver labs covering both adult male-to-female and female-to-male common genital gender affirming surgeries (GAS). This course is designed for the general urologist, but also offers substantial learning opportunities for the practicing gender surgeon. The course will be taught by leading clinical urology faculty from the U.S. and U.K. In addition, anatomists from the UCSF Department of Anatomy will also participate in teaching the cadaver-based lab portion of the course.

The didactic lectures will cover an introduction to the adult patient population, review of transgender epidemiologic data, review of culturally-competent terminology, review of current transgender care guidelines and what requirements patients must meet to qualify for genital GAS. Additional topics include a review of the medical specialties that routinely participate in adult transgender care and a review of both adult male-to-female (MtoF) and adult female-to-male (FtoM) genital gender affirming surgeries. Following the hands-on sessions, experts will discuss common post-op hospital pathways for both adult MtoF and FtoM genital gender affirming surgeries, common complications, the design and make-up of a balanced gender affirming surgery program, what surgical instruments the general urologist and practicing gender surgeon may find useful in daily practice and commonly used ICD diagnostic and CPT procedure codes. Throughout the course, attendees will have the opportunity to ask questions of all of the faculty.  

Hands-on lab sessions will cover the surgical steps and anatomic basis for both adult MtoF and FtoM genital gender affirming surgeries. Fresh human cadavers in various states of prosection will be presented. Surgical techniques, important surgical landmarks and clinical pitfalls will be reviewed. Each participant will be provided with their own individual iPad loaded with a review of the entire lab and live surgery videos.

Learning Objectives                                       

Upon completion of this course, attendees will be able to:

  • Use terminology related to the adult patient population and their care and appraise epidemiologic data about transgender people in the U.S.
  • Describe the related preparations adult transgender patients in the process of transition must complete before being ready to undergo genital gender affirming surgery (GAS).
  • Outline the principal surgical steps in FtoM genital surgery with metoidioplasty and phallo-urethroplasty and explain state how these can be staged.
  • Outline the principal surgical steps in MtoF genital surgery with vaginoplasty with and without creation of a neovagina and explain how these can be staged.
  • Describe important anatomic landmarks and key surgical steps for (MtoF) vaginoplasty and (FtoM) phallo-urethroplasty surgeries.
  • Identify what surgical instruments, dressings and durable medical goods are most useful with genital GAS.
  • Describe common genital GAS post-operative care pathways.
  • Review common surgical complications and their management.
  • Discuss common challenges patients face during recovery after surgery.

Course Director

Maurice Garcia, MD, MAS

Associate Clinical Professor in Residence
Director, Transgender Surgery Program
Division of Urology
Cedars-Sinai Medical Center
Los Angeles, California  

Associate Professor (Adjunct)
Department of Urology School of Medicine
University of California, San Francisco

Scientific Program Schedule

Thursday, May 17, 2018

7:00 a.m.

Shuttle Bus Departs from Moscone Convention Center for UCSF School of Medicine

7:30 a.m. - 8:25 a.m.

Registration and Breakfast

8:25 a.m. - 8:40 a.m.

Introduction and Pre-Course Assessment
Maurice M. Garcia, MD, MAS

8:40 a.m. - 8:47 a.m.

Introduction to the Patient Population, Culturally Sensitive Terminology, and Current Epidemiologic Data
Stan Honig, MD

8:50 a.m. - 8:57 a.m.

WPATH Professional Care Guidelines & an Overview of the Process of Gender Transition
Lee Zhao, MD

9:00 a.m. - 9:10 a.m.

Transgender Primary Care and Hormone Therapy (MtoF & FtoM)
Nick Gorton, MD

9:13 a.m. - 9:23 a.m.

Mental Health Care During Transition: Pre-Surgery Assessment
Dan Karasic, MD

9:25 a.m. - 9:32 a.m.

Essential Elements of the Urologist's New-Patient Visit Record for Care: Planning and/or Pre-Surgery Evaluation and Planning Post-Surgery Care
Maurice M. Garcia, MD, MAS

9:35 a.m. - 9:45 a.m.

Male-to-Female Genital Gender Affirming Surgery Options: Pre-Surgery Requirements
Philip Thomas, MBBS, FRCS

9:48 a.m. - 9:58 a.m.

Female-to-Male Genital Gender Affirming Surgery Options: Pre-Surgery Requirements
Maurice M. Garcia, MD, MAS

10 a.m. - 10:15 a.m.

Walk to UCSF Anatomy Lab

10:15 a.m. - 12:15 p.m.

Surgical Skills Stations:

Group A: LAB 1 - Male-to-Female Genital GAS, with complete vaginoplasty and creation of a neovaginal canal

Group B: LAB 2 - Female-to-Male Genital GAS, with two-stage radial artery forearm flap phallo-urethroplasty

12:15 p.m. - 1:15 p.m.


1:15 p.m. - 3:15 p.m.

Surgical Skills Stations:

Group A: LAB 2 - Female-to-Male Genital GAS, with two-stage radial artery forearm flap phallo-urethroplasty

Group B: LAB 1 - Male-to-Female Genital GAS, with complete vaginoplasty and creation of a neovaginal canal

3:15 p.m. - 3:40 p.m.

Coffee Break - Return to Lecture Hall

3:40 p.m. - 3:49 p.m.

Transgender Surgery: The Role, Design and Key Components within a University and a Managed Care System
Maurice M. Garcia, MD, MAS, and Polina Reyblat, MD

3:51 p.m. - 4:00 p.m.

The Role of an Academic Human Anatomy Program to Transgender Surgical Anatomy Education
Kimberly Topp, MD, and Derek Harmon, MD

4:02 p.m. - 4:09 p.m.

ICD Diagnosis and CPT Billing Codes for Transgender Surgery
Polina Reyblat, MD

4:12 p.m. - 4:21 p.m.

Organization of the Operating Room
Nim Christopher, Mphil, FRCS, Philip Thomas, MBBS, FRCS, and Lee Zhao, MD

4:24 p.m. - 4:33 p.m.

Post-Surgery Care: Strategies to Optimize Outcomes and Guard Against Pitfalls
Nim Christopher, Mphil, FRCS, and Maurine M. Garcia, MD, MAS

4:36 p.m. - 4:45 p.m.

Transgender Surgery: Providing Valuable Care as a General Urologist
David Ralph, MD, and Maurice M. Garcia, MD, MAS

4:45 p.m. - 5:15 p.m.

Panel Discussion: Q&A

Panel: Nim Christopher, Mphil, FRCS, Stan Hoenig, MD, David Ralph, MD, Polina Reyblat, MD, Philip Thomas, MBBS, FRCS, and Lee Zhao, MD

Moderator: Maurice M. Garcia, MD, MAS

    • Managing common complications: MtoF and FtoM

    • Controversies in transgender surgery lacking evidence-based data

5:15 p.m. - 5:30 p.m.

Post-Course Assessment

5:45 p.m.

Shuttle Bus Departs UCSF School of Medicine for Moscone Convention Center

Course Registration Fees

Registration Fees


Standard Pricing


Cancellation Policy

Live Course: An administrative fee of 15% is assessed if registration is cancelled up to six weeks prior to the course. If registration is cancelled four to six weeks from the course, the cancellation fee is 50% of the registration fee paid. No registration fees will be refunded less than four weeks prior to the course.  

AUA Education & Research reserves the right to cancel this course if a minimum enrollment is not reached before April 5, 2018. If AUA Education & Research cancels this course, registration fees will be refunded in full and notification will be sent by April 19, 2018.  

Cancellations must be made in writing. Requests may be made via mail or fax to 410-689-3912. Questions? Call 1-800-908-9414 or email

Attendee Information & Policies


The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the American Urological Association (AUA).  

Consent to Use of Photographic Images

Registration and attendance at or participation in AUA meetings and other activities constitutes an agreement by the registrant to AUA's use and distribution (both now and in the future) of the registrant or attendee's image or voice in photographs, videotapes, electronic reproduction and audiotapes of such events and activities.  

Audio, Video, Photographic Equipment

The use of audio, video and other photographic recording equipment by attendees is prohibited inside AUA meeting rooms.

Reproduction Permission

Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the AUA.

Special Assistance/Dietary Needs

The AUA complies with the Americans with Disabilities Act §12112(a). If any participant is in need of special assistance or has any dietary restrictions, please see the registration desk.

Course Location/Hotel Information

Course Location

University of California, San Francisco
Parnassus Campus
505 Parnassus Ave
San Francisco, CA 94143  

Hotel Information                  

Visit for travel recommendations for AUA2018. 


Call 1-800-908-3917 or email

CME Information


The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

The American Urological Association designates this live activity for a maximum of 7.00 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Other Learners

The AUA is not accredited to offer credit to participants who are not MDs or DOs. However, the AUA will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 CreditTM.

Evidence-Based Content

It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.

AUA Disclosure Policy

All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) participating in an educational activity provided by the AUA are required to disclose to the provider any relevant financial relationships with any commercial interest. The AUA must determine if the individual's relationships may influence the educational content and resolve any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.

Resolution of Identified Conflict of Interest

All disclosures will be reviewed by the program/course directors or editors for identification of conflicts of interest. Peer reviewers, working with the program directors and/or editors, will document the mechanism(s) for management and resolution of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to resolve conflict of interest:

  • Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or Education Content Review Committee or its subgroup
  • Limit content to evidence with no recommendations
  • Introduction of a debate format with an unbiased moderator (point-counterpoint)
  • Inclusion of moderated panel discussion
  • Publication of a parallel or rebuttal article for an article that is felt to be biased
  • Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
  • Divestiture of the relationship by faculty

Off-label or Unapproved Use of Drugs or Devices

It is the policy of the AUA to require the disclosure of all references to off-label or unapproved uses of drugs or devices prior to the presentation of educational content. The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the prescribing information for full disclosure of approved uses.