Nobody needs all of it, and plenty of trans women have none. Most start with hormones and give them a couple of years to work. Facial feminisation and breast augmentation often come before genital surgery, if genital surgery happens at all; vaginoplasty tends to be the last and biggest decision. Start Here walks through every procedure and the order most people have them in.

Genital surgery (vaginoplasty, or an orchiectomy on its own), breast augmentation, facial feminisation surgery, body feminisation such as liposuction and fat grafting to the hips, and voice surgery. Each gets its own guide as the site grows; for now Start Here has the short version of each.

For genital surgery, almost always: most surgeons and funders want a period on hormones, often around a year, unless there is a medical reason not to. For breast augmentation, surgeons usually prefer to wait until oestrogen has done what it will, which can take two years or more. Facial surgery has fewer rules attached. The details live in Start Here.

It varies a lot by country and surgeon. Self-pay in the US, vaginoplasty is typically in the tens of thousands of dollars, facial feminisation can be a similar figure across several procedures, and breast augmentation is usually less. Prices in Thailand and parts of Europe are often lower. Each guide will carry a cost table with hedged ranges rather than a single number; the outline is in Start Here.

Often for genital surgery, with paperwork: letters of support, time on hormones and sometimes a BMI range. Breast augmentation is covered less consistently, and facial feminisation is rarely funded anywhere, though this is slowly changing. NHS waits are measured in years rather than months. Start Here covers the process from referral to surgery day.

Look for someone who does your procedure every week, not occasionally, and ask about their complication rate, their revision policy and results on bodies like yours. Distance matters less than people think; follow-up matters more. Start Here has the questions to ask at a consultation, and if you know a surgeon who should be listed, tell me.