A Comprehensive Guide to Dr. Brassard, Montreal, Canada

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In October 2019 I underwent bottom surgery (MtF) in Montreal. I have decided to write a little guide that will hopefully explain some thing I wish that I knew going in. This is going to be a long and comprehensive guide pushing reddit's word count. Grab a cup of tea. Now I gotta say, I've never used reddit before besides finding information on it through google so please bear with me.

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The Start

I live in Ontario and we get our surgery costs covered through the government. The process involves being cleared by two health professionals and minimum one year hormone therapy (If I remember correctly). I saw a clinical psychologist as one of my specialists and the other came from the office of the doctor who prescribes me my hormones. Now this doctor has a system set up along with a nurse practitioner who oversees transgender care in their office so your second person may need to be different.

However, once you have received the go ahead from two specialists your information will be sent off to be approved. You also get to choose your doctor. It does not need to be Dr. Brassard. I had originally wanted to go see a doctor in California. I sent my information in, it got approved by the health system, and then I had to contact them.

[Aside]: I cannot stress this enough. You need to take an active role in setting up the surgery. For out of country surgery or otherwise. The doctors/receptionists/nurses only have so much information between conflicting healthcare systems. If you assume your doctor is setting everything up for you don't be surprised when you find out that maybe a surgeon has received your information but is waiting on YOU to call and set up a consultation. More on this later.

I ended up not going to California as the doctor I had considered posted a gallery of his work with no so great results (and this is what he was showing off on his website). So I resubmitted for Dr. Brassard.

It takes about 3 Months for your paperwork to go through. Now, at about month 4 I still had not heard anything so I called their Montreal offices. It turns out they had received my information and now were waiting for me to complete some more forms for them....This is what I talk about in the aside. Frustrating? Yes. But I now knew how involved I was gonna have to be.

I was sent an " Acknowledgement of Receipt and Missing Document Form " What they needed from me was:

• Hormonotherapy report from your prescribing physician
• Current list of medications provided by the pharmacy
• Health Questionnaire (Which they provide in email)
• Picture from head to toe fully clothed

I was able to collect all this on my day off work. Its not a lot really.

After submitting all this I received a confirmation email back saying:

"Please take note that we have received the documents you sent us, and your file has been transferred to the preoperative clinic for assessment and to ensure that the documents are meeting the WPATH and GrS Montréal criteria.

During the evaluation of your file, if additional information is required a nurse from the preoperative clinic will contact you or your healthcare professionals. Once the evaluation is completed, you will be contacted to offer you a date for your surgery."

Great! Progress!

The date of that email was the 22 of January. They could not give me an estimate for how long it would take to process and, admittedly, I may have bugged them more than I should have about it at this point haha. I was emailing them every 3 weeks looking for updates. This may have been completely unnecessary but at this point I was engaged!

[4 Months Later]

I was at work when I received their call. May 1st . It was short, sweet and to the point. I had been approved. The date they offered me was October 7th. I asked if it could be sooner, just because why not? It could not be sooner. Oh well. 6 Months . Felt like forever away. when October 5th came and I was packing to leave...I wondered how 6 months went by so fast.

In between:

I was sent 3 forms at the end of June:

• Preoperative and Postoperative Planning Form
• Medical Health Questionnaire
• Information and Acknowledgement Form

You will also have to send them $40 for the medication you will receive when you're there. You can do this in many ways. I simply called them up and gave them my credit card information. Easy peasy.

I also had to get a CBC Blood Test which you can get from your doctor.

These forms will take a better part of an afternoon to complete.

The Preoperative and Postoperative Planning Form:

Covers information about your travel arrangements (If you are staying at the Holiday Inn de Laval) Which is paid for and booked by them as well as the limo after your stay (and yes it is a private 3 seat limo not a taxi. I assumed this was just a french colloquialism for taxi so I was surprised!) However you will Taxi there the day of your surgery which is also paid for by them.

It also covers information about your stay at the hospital and visiting hours .

The Medical Health Questionnaire:

Is a basic medical health/surgical questionnaire. The shortest of the forms.

* Information and Acknowledgement Form:\ *

This is a large information pack that has a TON of information about your surgery. I have uploaded a copy of and I highly recommend you read it. This has information for both Canadian and foreign patients.

https://www.scribd.com/document/445569325/Pochette-Imp-Vagino-Ang

You may hyperventilate a little reading about the procedure but it's gonna be okay. It covers everything that could go wrong and everything that will go right.

The Surgery (Arrival):

Oh boy! Here we Go!

Everyone at the hotel and at GRS Montreal is Bilingual if that is something you are worrying about. You do not need to speak French at any point.

If you also work full time don't be surprised when all of a sudden 6 months has gone by like 6 weeks. It hit me like a ton of bricks packing for my trip. I drove to Montreal with my parents and my boyfriend. I arrived at the Holiday Inn de Laval 2 days before the surgery date and was quickly checked in. The Holiday Inn has done this many times and don't be surprised if you notice a bunch of other trans folks walking the halls. You are given a card with $50 on it for your meals and for breakfast for each day if I remember correctly (I don't remember paying for meals is what I'm saying). There are two restaurants attached to the hotel as well as room service.

You will have one full day to yourself before the surgery. There is a mall across the road as well as many other restaurants surrounding. Everything you've suppressed worrying about is gonna come down on you this day. For me, I turned into a spacey mess. My parents and boyfriend are wonderful and kept asking me what I wanted to do that day. I eventually told them that "I want someone else to decide, please. Just help distract me."

You will have to give yourself 2 enemas that day. Which will also be provided by GRS Montreal/The Holiday Inn. You will find them in your room's bathroom as well as instructions for your day. I wish I kept a copy to show you, sorry. One at 3pm and before bed I believe.

You will also be required to shave with an electric razor, your bits and the surrounding area. I don't know why electric but they seem to stress an electric shaver.

Enjoy your day as best you can. Prepare yourself mentally as best you can. Your life is about to change.

The Surgery (Day of):

You'll wake up, pack your things and go downstairs. You have a voucher for a taxi that will take you to GRS Montreal. Simply speak to the receptionist and they will take care of everything. GRS Montreal is a beautiful building. They may have you fill out a few more forms. One will be a consent form that they may show off surgical photos for training/educational purposes.

[Aside]: I have read more than once that Dr. Brassard makes you sign a NDA about showing your surgery results. I never encountered this anywhere and I'm not sure where this information is coming from. As you will see, I am able to post my results without any worry of legal repercussions .

You'll then be taken back to see a few nurses. They will again ask you a few medical questions, take your pulse, blood pressure etc. My anesthesiologist also popped in during this and said hello. Everyone is very friendly. You'll be given some medication (Oxycodone, an anti inflammatory and antibiotics if I remember) and a gown to wear and brought into a hospital room. This is the same room I recovered in over the next 2 days before being moved to their recovery center.

You'll then get to meet the man himself if you haven't already. (Or Dr. Maud Bélanger if she's doing your surgery I would assume.)

Dr. Brassard is a very nice man. It's clear he cares about you, this isn't just a vagina factory to him.

He told me that they would be giving me a needle in my spine to numb my bottom half and an I.V. in my hand and that we would perform the operation at about 11:30. It was about 10am at the time. Now what happened next is something I laugh about but was distressing to my parents and boyfriend at the time. They were allowed in the room I was in while I waited. My mother went to the bathroom at about 11am and a nurse came in to fetch me. I assumed they would be taking me to get my I.V. and spine needle and then bring me back to the room. Sike! I was going for surgery now. So without saying goodbye to my parents and boyfriend I follow this nurse. She takes me into a small waiting room and said she would fetch me in about 15 minutes. The realization of that "Oh...we're going NOW." hit me. She told me to use the bathroom if I needed to and left. I knew this would be the last time I could pee standing up and took full advantage of that. She came back 2 minutes later.

"Alright, are you ready?"

"Ready as I'll ever be."

I was led into their operating room. Everyone had big smiles for me. They got me to hug a pillow and lean forward sitting on the table while they gave me a needle in my spine. Honestly the I.V. hurt more which surprised me because it was a normal I.V. They strapped my arms down on this crucifix shaped operating table (such symbolism right?) They gave me my I.V. while doctors set up tables, nurses talked to doctors. The anesthesiologist started massaging my head and-

I woke up to a blue curtain separating my top and bottom half. I was told I did great. They told me they're gonna move me now. Several people helped slide me onto a rolling bed. I was wheeled off into a recovery room for about an hour. I could think clearly, which was surprising. I stared out the window at a tree. It was a sunny day. The leaves fluttered and danced with the light. I wondered how many people had stared at that same tree.

Beeps, boops, hospital sounds.

I was there for about an hour before they came back in and took me to my original room. I have a roommate now. We would be together in their recovery center (L'asclepaide) as well, I don't know if this is always the case.

I asked the nurse if my family was still here. She said no, they had left. After learning that I was having the surgery NOW. My father convinced my mother that there was no point waiting here as the surgery was set to take 4 hours. In reality it took about 3 . They had gone to get some food for their AirBnB stay. For whatever reason I decided to give my boyfriend my phone to hold onto instead of putting it in my bag which was next to me. So I notice a phone by my bed and the nurse pulls it closer for me. I call my Mother's cellphone and of course her heart sinks because caller I.D. says GRS Montreal is calling and of course she's gonna assume the worst haha.

I could not feel anything below. The rest of the day I was given medications routinely and feeling came back in the evening. It ached. However the nursing staff are great about managing pain. They will routinely ask you how you are feeling pain wise. If you tell them you're at a 5 out of 10, they're gonna give you more medication.

This is where I will give you the biggest advice for your recovery.

Don't be a hero.

I learned this the hard way.

The second day they will want you to get out of bed and take a small walk around the nurse's station. My first time went well. They will ask you to do this again a few more times. That same day after dinner (The pain medication made me nauseous) They tried to get me to walk again. I got halfway out of the room and told them I felt like throwing up. They laid me back down no problem. Then my roommate went out and circles no problem. Admittedly, I was envious and wanted to as well. So after about an hour I asked the nurse if I could try again. They said sure. I made it about half way around before I started feeling sick. But I kept going. 3/4 of the way around I was rushed to the nearest bathroom. I was about to experience the worst pain of my life. I was now throwing up in their bathroom sink, leaning on the counter for support while a nurse held me up. My muscles were contracting, yes those ones, I was crying, screaming, throwing up. They brought me back to my room in a wheelchair. Don't be a hero. I wasn't the only one to learn this.

Meals were provided with a variety of selections. Not bad food at all.

The rest of the time in the hospital was uneventful. Watched a lot of youtube (Free wifi!)

They will change your dressing as well as bring you ice for swelling regularly but they will also at some point teach you how to change your own dressing.

There will be a portion of dressing sutured to your body for the majority of your time there. Sounds scary but it doesn't hurt unless you were to pull on it. Which you won't. As well as a stent inside of you to keep your vagina from sealing closed.

They moved me the next day to their recovery center in a wheelchair. Admittedly I told them I needed one, traumatized by the idea of a repeat of the day before.

L'asclépiade (Recovery Center)

They wheeled me over, sitting on an inflatable donut to L'asclépiade which for those who don't know, is their recovery center where you will spend the rest of your time in Montreal. I can best describe it as an old Victorian house which has been converted and attached to GRS Montreal via a hallway. You can search L'asclépiade on google maps and find a few pictures that give you a decent layout of the amenities. Then they told me I would have to get out of my wheelchair and go up 1.5 flights of stairs to my room. Note, that there are rooms on the first floor, it just so happened that mine was on the second floor. I managed to make it to my room without incident. My roommate and I had a bathroom in our room while the single rooms seemed to have bathrooms assigned in the hallways. There are a lot of bathrooms.

I believe I was there 6 days. The food they serve is fantastic. Well above hospital food standard. There was only one meal I didn't wanna eat and only because I'm not a fan of salmon. In that case I asked if I was able to order UBER Eats and they said it was no problem and just to let them know, so they know I had eaten something. They will also be making sure you're drinking lots of water your entire stay and I recommend it as it will affect your healing.

You'll be given a booklet on your first day outlining what to expect during your stay.

This booklet is available online here:

https://www.grsmontreal.com/DATA/TEXTEDOC/8X11WEB-Vaginoplastie-2013-ASC---En-V55.pdf

You will have a catheter with a switch that you control. So I guess technically you'll still be standing to pee a little longer.

They will stress hygiene constantly and I suggest you take it very seriously. Even though you haven't showered for a few days now.

Your first bowel movement is gonna be hard. Mostly because the bottom of your butt is sewn closed with 3 or 4 stitches to keep the stent in place. The toilets have mobility handlebars (Imagine armrests on a toilet) I recommend placing one butt cheek on the seat and flopping over to one side like you're praying to god, to get comfy. Also put a towel on the bar so your arms don't fall asleep.

Blood Drain

One thing I have not heard anyone talk about is the blood drain. It is a plastic bulb that is inserted to stop blood clots from forming. It is removed on one of the first days at L'asclépiade by one of the nurses. This leaves its own scar on your body which after 4 months has still not faded. This does not feel good coming out, I don't wanna scare anyone, it comes out fast, but it doesn't feel good. (See pictures)

Milestone Days:

The first few days, you will continue changing your dressing as normal. You will then hit some milestones in your stay that I will go into detail about now. (However there is more detail in the booklet as well) They are as followed:

(Note that the "day number" is from your first day at L'asclépiade and not from the surgery date.)

• Removal of Genital Dressing (Day 4)
• First Bath (Day 4)
• Removal of Stent (Day 5)
• First Dilation (Day 5)
• First Douche (Day 5)
• Removal of Catheter (Day 6)

Removal of Genital Dressing

The removal of the dressing is the first time you will see your vagina. They snip the stitches holding it in place. This will happen in the nurses room contained within L'asclépiade. It pinches a little as they cut them. Otherwise, not painful.

First Bath

Your first bath will be nice. Before this you're only allowed to wash your hair and freshen up with baby wipes if I remember correctly.

Removal of Stent

The removal of the stent is done in the same nurses office. The stitches holding it in place feel a bit pinchy getting removed but the removal of the stent feels great. Like a giant relief of pressure. You'll immediately start feeling more mobile.

First Dilation

A nurse will guide you through your first dilation. Welcome to the world of dilation. It will become your life over the next 3 months. More on this later. Dilating didn't hurt for me however my roommate seemed to have some discomfort. From then on you will be dilating, showering and air drying your vagina throughout the day.

First Douche

Douching is douching. You'll receive two big bottles of saline (Often referred to as NaCl ) and you'll also be taught how to make saline for when you get home. (Super easy) Douching isn't painful and there isn't much to say about it.

Removal of Catheter

For whatever reason they got me to come down at something like 5:30am or 6am to have my catheter removed. They told me that my urethra was too inflamed to take it out just yet. I was told they would check again in the afternoon. So I started drinking cranberry juice like it was going out of style. The reason for this is that if you don't get it removed there then you're given a prescription to have it removed by a doctor back home...in one week's time. I hated this catheter so I was poised to do whatever I could to have it removed as quick as possible. They checked me again in the afternoon and said the swelling had gone down a bit, but there was a 50/50 chance that if they removed it and I couldn't pee that they would have to put it back in again. Now I'm not a big gambler, but the thought of having this thing in me another week outweighed the thought of whatever brief pain there would be if they DID have to put it back in. However the nurse also said we could wait until after dinner and see. We went with that option and it came out that evening. Little bit of burning but hey that's catheters for you.

As a funny note, your first pee is gonna be weird. Peeing with a penis, there is a distinct pressure feeling at the head when you're about to let loose. You still feel that for a while after surgery, but it comes out nowhere near where you expect it to come out haha. "Ghost limbs".

Between all this

Between all this your biggest obstacle will be boredom. You can sign out and take a walk if you'd like, there is a nice park by the river if you're feeling up to it. Otherwise bring lots to keep you busy. It brought both me and some other girls to tears at points. This isn't a vacation in Montreal after all. You'll get home sick fast and you'll love and hate L'asclépiade. It's hard to describe.

Leaving

Whatever plans you have on getting home you will coordinate with the staff. For me I was flying back to Toronto and being driven the rest of the way. I checked out with them, they helped me carry my bags down, they gave me some medication for the week and I was on my way! I can't be more grateful to all the staff there. They make you feel like you're more than just a patient. They are there to help you every step of the way. Montreal has been the only place in Canada for the longest time able to do these kinds of surgeries and it is only now recently a center in Toronto is opening up. This is their life's work, they have this down to a science. At first I can admit that I saw them as a vagina factory but what I came to learn was that they are one of, if not THE best center to receive care at . I would highly recommend them if you are looking for a surgeon.

The Realities of Home

The next 3 months of your life are going to be nothing but dilating. Have a boyfriend/girlfriend? Wanna go to their place? You're bringing all your supplies with you. That includes your dilators, saline, baby wipes, your douche and disposable mats so you don't make a mess of their bed. Wanna go out and watch a movie? Better make sure it fits in your dilating schedule. You can read more about what the actual schedule is like in the post operative guide linked above. But come to terms with the fact that you won't be getting up too much unless you can slot it into your dilating schedule. You're gonna be tired. Don't be a hero. One day I had plans to go to a farmers market with my boyfriend. I could only make it to the car before crying and cancelling plans because I was too tired. If you don't have the energy, don't try it. This isn't a vacation, this is a recovery.

Work and Employment Insurance

You must ask GRS Montreal for a medical certificate if you are planning to apply for employment insurance. Also, they give you a timeline of when you can go back to work however this may not be the date listed on your medical certificate. For me I was covered for an extra 3 weeks which I was able to continue taking time off work. This was over the Christmas season so I calculated I would be making more money from EI than going back to work part time/holidays (In align with my dilating schedule). I had never been on EI before so I did not realize it takes up to a month to process your EI forms. Fill these out as soon as you possibly can. In Canada you can do everything online.

The Fun Stuff

Now the fun stuff. Because we're all eager to know what we can do with our new body. 4 months in I'm still discovering new things! This Section is NSFW. I'm not going to be coy.

I cannot speak for everyone's results however here is what I have experienced so far.

Masturbation

My clitoris is sensitive and orgasmic . My first orgasm was just before week 8 (You are supposed to wait until week 8, I couldn't) Have fun with it . Don't take it too seriously. If it doesn't work one day, try again another day. I suggest watching lots of porn without touching yourself to get fired up and desperate, it will help expedite the process.

Sex

Sex is great. At week 12 you can begin having sex. I can cum from being fucked and it is now my new preferred way to cum. I can do this with my boyfriend or with a dildo. I honestly wasn't expecting so much sensation.

The Future

I am still only in the 4th month of recovery while writing this. I will update it as I see fit. I hope that you can take away some useful information from my experience but at this point I have run out of things to say. I will try to answer questions as best I can, but given time I'm sure I will forget about this post.

Take Care

-Anonymous