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A Guide to SRS

Dr Chayamote Chayangsu MD. (Dr “Bank”) & Dr Navipa Dusitanond (Dr "Prae") - Suporn Clinic

Location

Chon Buri, Thailand. Operates out of Samitivej Chonburi Hospital.

Costs

(Thai Baht)Dr BankDr Prae
2025650000560000
2026690000600000

~28000-32000 AUD depending on exchange rate.

  • This cost (to my knowledge) is all inclusive of travel within Thailand (not flights), the surgery, hospital stay, all post-operative care (including dilators, etc.), as well as accomodation.
  • Additional required medical procedures are covered. As well as free “cosmetic improvement surgery” as needed/requested for a limited time.
  • Source: Overall cost & Details

Booking system

  • “Suporn clinic uses a lottery system, where they open their calendar every 3 months to request your appointment. It may take several attempts before you get selected to have an appointment. I had to wait a year. ” Source

Method and surgical experience

The Suporn clinic performs the Suporn technique of vaginoplasty.

  • Dr Bank is the primary surgeon at this clinic, with Dr Prae assisting. Dr Bank has been performing this technique since 2018.
  • No specific numbers are posted, but my best guess is that Dr Bank has performed hundreds if not more surgeries (As Dr Suporn had performed 2500 SRS by 2017).
  • There is no information on the number of surgeries Dr Prae has performed/assisted. Or much information about her available at all https://www.medtravel.asia/listing/dr-navipa-dusitanond-md-chonburi/
  • As well on that page is a presentation on the technique. Be warned it has some graphic surgical images.

Online reports of the experience

Suporn Clinic website

https://supornclinic.com/

Rk’s experience

Why Dr Prae?

I had considered other options too, both locally in Australia and abroad. I had consulted with Dr Saran Wannachamras (Thailand), Dr Chettawut Tulayaphanich (Thailand), Dr Yasas Abeywickrama (Sri Lanka) and Dr David Caminer (Sydney). At the time of enquiring, Dr Andrew Ives (Melbourne) was not taking cases for SRS. Two doctors recommended SRS with a colon graft while the other two only performed penile inversion. As I had limited donor material to work with, I wanted to go with a non-inversion technique, and I wanted it to be self lubricating. I had concerns with using a colon graft and was worried about the complications that could arise from using peritoneal tissue. Suporn seemed to be my only option to get the result I was after.

I applied for the Bank lottery for the Jan - April 2025 round in late 2023, and was not successful. I was offered to go in to the lottery for Dr Navipa Dusitanond, better known as Dr Prae for July-Sept 2024 as a consolation, with a heavily discounted price of 540,000 THB, and secured a date for September 2024.

Dr Prae was not my first choice of surgeon - I had wanted to go with Dr Bank initially. I was not willing to wait another six months and I decided to take a gamble on Prae. It was her first round of solo efforts. She had been with the clinic since 2019, working with Dr Bank doing team surgery, so I hoped that her work would be just as good, and that the clinic would not put their reputation on the line if they didn’t think she would do a good job.

Despite my reservations, Dr Prae turned out to be a good fit for me. I’ve heard that Dr Bank’s bedside manner can be quite curt, but I’ve never really had any proper interactions with him. Dr Prae was very friendly, answering my questions with an air of confidence and calm in a way that was very reassuring for me, especially in the rocky weeks following the surgery.

What was the process of getting to surgery?

  1. Contact the clinic by email with a completed client information form. This allows the clinic to have your details on file, let you know if there is anything that may preclude you from surgery, and serve as a point of contact.
  2. Wait for the surgery to announce their next batch of dates. Once they go out, email the clinic with a preference of dates (if any preference) and wait for a response.
  3. The clinic will then email you to advise you of a date (if successful). A 10% deposit has to be paid to reserve the surgery date. It is important to keep the clinic informed of any changes to your medical status in the waiting period between acceptance and your surgery. A 100% refund is provided up until 3 months prior to surgery.
  4. A psychiatric assessment and WPATH surgery recommendation is required from a local psychiatrist confirming that you consent to having surgery and that surgery is recommended for treating your gender dysphoria.
  5. Closer to surgery (3 months prior), the clinic will email to ask for passport and itinerary details to arrange for airport transfer, arrange your hotel reservation at the Rattanachol Hotel, as well as remind you of pre-op requirements and any outstanding balance on the account. They will also direct you to install LINE on your phone, which is what they primarily use for contact whilst in Thailand.
  6. Upon arrival in Thailand, you will be directed to meet with a liaison at the airport, who will accompany you to the shuttle that takes you to the hotel, where you will be checked in. The clinic will keep in touch with you to advise of your appointments. The clinic will shuttle you from the hotel to the clinic and hospital for your appointments throughout the course of your stay, at no cost.
  7. There is a pre-op appointment at the clinic, where you will be directed to sign consent forms and consult with your surgeon. There is also a pre-op health screening that is done at the hospital, that involves taking blood samples, X-rays and cardiograms.
  8. You will be checked into the hospital the day prior to your surgery, where you will undergo a 2nd psychiatric assessment, meet with your anaesthetist and have an enema administered. This is your last day of freedom.
  9. All going well, you will be wheeled out to OR at 8am (see notes below).

Pre op requirements?

Copied from my surgery offer email:

  • You are responsible for updating your client profile and making sure that all your personal information, health, medical records and lists of previous surgeries are up-to-date and accurate at all times. It is very important that we have the latest list of your current medication before surgery. In the event that we find your undisclosed and/or inaccurate information, medical records, previous surgeries or psychological complaint during the examination or prior to your surgery, which you could reasonably have been aware, you will be deemed to have cancelled the surgery on your own volition. All payment will be forfeited. No future rescheduling allowed.
  • Your BMI must be between 18 to 30. If your BMI is below 18 or above 30 by the time you arrive in Thailand, we reserve the right to cancel your surgery. Penalty fee applied. For your best result, please maintain your BMI below 28. If your current BMI is more than 28, our team will reach out to you to update your BMI 3-4 months before your surgery date. If you believe that you could not maintain your BMI below 30, or best below 28, around 3.5 months before the surgery date. Please contact us to reschedule your surgery date. Rescheduling fee applied if you reschedule less than 90 days before your surgery date.
  • If you wish to undergo Facial Feminization Surgery (FFS) or voice surgery before your SRS, FFS and/or voice surgery must be completed at least 6 months before your SRS. For your safety, we will cancel your surgery if you do not meet required our conditions. Penalty fee applied. For other surgeries, such as breast augmentation and other surgeries that do not take longer than 2 hours under general anesthesia, please spare at least 3 months. If you are not sure, please confirm with us.
  • You must never undergo Brazilian Butt Lift (BBL) or Buttock Enhancement. If you have undergone this operation in the past, please contact us to discuss your case. Do not transfer your deposit until further advised.
  • You are responsible to obtain ONE referral letter that contains all required information. The issued date of your letter must not exceed 2 years from the date of your surgery. The letter must be addressed to Dr. Navipa Dusitanond or The Suporn Clinic. If you are unable to obtain the letter from a psychiatrist (MD) or clinical/ licensed psychologist with valid license number, please discuss your case with the admin team. We strongly advise that you check with us your if your referrer is qualified before paying to issue the letter. Please note that counsellor, licenced clinical social worker, sexologist or gender specialist are not psychologist.
  • You must meet with a Thai psychiatrist to obtain your second referral letter prior to your surgery in Chonburi. In events that Thai psychiatrist finds you unsuitable for the surgery for any reasons, we reserve right to cancel your surgery. Penalty fees will be discussed case-by-case.
  • It is mandatory that you must stop all kinds of hormones and anti-androgens at least 2 weeks before your surgery date. If implant is used, please make sure that your last implant runs down 2 weeks before your surgery date. This is to reduce the risk of DVT during and after your surgery as you must stay in bed with limited mobility for a few days. We may randomly check the hormone level in your blood circulation (as part of pre-op check-up). If a certain level of hormone is found, we reserve the right to cancel your surgery. Penalty fee applied.
  • You must stop all kinds of marijuana/ cannabis related products, its derivatives and all medications that contain marijuana or its derivatives at least 1 month before your surgery date. If your current medication includes marijuana/ cannabis of any forms, you MUST inform the medical team and provide a medical certificate and your latest physician’s prescriptions at least 1 month before your surgery date. We may do a test for addictive substances as part of a pre-op check-up. If a certain level of addictive substances is found, we reserve the right to cancel your surgery. Penalty fee applied. You must not consume any marijuana/ cannabis related products during all your recovery time in Thailand.
  • You and your accompanied person (s) must complete COVID-19 vaccination in accordance with the requirements of each brand and must completed all required dose(s) no less than 14 days before your departure date from your country. Booster shot is advised (not required) if your last shot is more than 6 months before your departure date from your country.

Costs involved?

  • Initial surgery amount: 540,000 THB

  • Hotel was booked in two parts: 3,900 THB for the first 3 days, and then 35,150 THB for the remaining 19 nights. This was because we decided not to pay for the 7 days that we remained at the hospital (my partner stayed with me at the hospital suite)

  • Return flights were AU$1,900 from Melbourne to Bangkok (BKK). I cannot remember if this was for one or two tickets.

  • We had a complication where my surgery was postponed for two weeks as I’d gotten ill with a throat infection on the way to Thailand, which, despite my concerns, I was allowed to proceed ahead with being checked into hospital. I had my surgery cancelled less than an hour before I was supposed to get wheeled to OR. This involved paying the hospital 22,400 THB for the overnight stay, paying AU$1,100 to have our flights rescheduled and an additional 15,000 THB for the additional week we were at the hotel.

What was your timeline?

July 2023 - Initial expression of desire to proceed with SRS. Emails sent to surgeons for quotes and consultations

December 2023/Jan 2024 - Applied for SRS with Suporn Clinic

Feb 2024 - Offered date with Dr Prae September 2024. Initial deposit sent

July 2024 - Final amount paid to Suporn Clinic to secure surgery

7th September 2024 - Flight to BKK

8th September 2024 - Landed in BKK, transfer to hotel

9th September - Clinic paperwork, health checks, Covid test, transferred to hospital for blood tests

10th September - Checked into hospital, consulted with psych (cleared), consulted with anaesthetist. Administered IV antibiotics and given sleeping pill

11th September - Anaesthetist postponed surgery to 22nd September. Returned to hotel.

21st September - Checked back into hospital. Anaesthetist confirmed all OK to proceed with surgery

22nd September - Surgery

24th September - Gastrointestinal complication, administered anti-diarrhoea medication

29th September - Transferred back to hotel. First dilation

8th October - Switched from static to dynamic dilations1^1, three times daily

18th October - Return to Australia

20th Jan 2025 - Reduced to two daily dilations

24th March - Reduced to one daily dilation

How was recovery?

Mixed. It was a pretty rough landing into post-op life, with the gastro at the hospital and the pain I was in, but my results have been pretty good so far. I still struggle with overly sensitive parts of my vulva and urination issues, as well as some granulation bleeding from inside the vagina.

Were you given any recovery information?

All patients are given a pre-op book with information, as well as a post-op book with details on dilating and what to do if you have complications. There is also a post-op class provided by the staff at the clinic. The clinic is reachable via LINE whilst you are in Thailand, and the pre-op book includes direct mobile numbers for staff in case of an emergency.

What was Dr Prae like to interact with?

Dr Prae is amazing. She was kind and approachable, very friendly and very knowledgeable. Interacting with her was very reassuring, especially if I found myself doubting any of the advice I was getting from other Suporn clinic staff or patients. I hear her bedside manner is significantly more approachable and friendly vs Dr Bank, who can be quite curt.

How was the hospital?

Pretty decent. The hospital itself was reasonably clean (although one of the suites we were in had a run-down bathroom), and comfortable. Each suite contains a bathroom, mini fridge, TV and spare bed for your support person. Nurses were reasonably responsive, although it sometimes took two or three calls before you were attended to. Hospital stay is 7 days and included in the surgery cost, but you may be charged for extraneous complications during your stay (I had a severe bout of diarrhoea on the 2nd day, which necessitated multiple nurse calls and medication to slow down my gastrointestinal tract. The added attention cost us another 22,000 THB)

Did you have any complications?

  • As above: two days after surgery, a bout of diarrhoea occupied the nurses for quite a significant portion of the day. We’d burned through the supply of puppy pads that the clinic had provided us and had to purchase more

  • I was sent back to the hotel with the catheter as I had failed to urinate on the last day of my hospital stay. The catheter was removed a week later. The first urination was difficult, but very rewarding.

  • Just before leaving Thailand, I had contracted a UTI, which made urinating extremely painful and difficult. The clinic rushed over antibiotics to attempt to treat the issue. Whilst the UTI has subsided, I continue to have ongoing urinary tract issues (not a UTI, but frequent urinations, slow urine flow, urinary retention after voiding and accidental voiding) that have necessitated me having to get a cystoscopy done by a urologist in Australia to investigate a possible stricture in the tract. This has not yet been completed.

  • Clitoral hood fusion on one side where my clitoris had partially joined itself with the clitoral hood/labia minora on the inside. Allegedly this is a common issue and might even be intentional. I’m less concerned about aesthetic and more about function, as I was worried it would impact mobility. At times I feel it tugging when I’m moving around. It can be fixed in revision.

  • A higher than expected amount of pain, which impacted mobility for about 4 months. I purchased a cane from Chemist Warehouse (AU$20), which helped immensely, not only with mobility during the recovery period, but also lead to members of the general public making space for me on PT (IE, in priority seats). The cane was able to be ditched after 3 months.

Are there any resources that you found helpful?

  • The Astra discord server. This is an invite-only space for Suporn clinic patients and their support people. Access is by word of mouth only. I had found a great deal of help just from talking to people in the server, as well as venting/documenting my recovery. The server is also a good way to co-ordinate with people on the ground in Chon Buri for arranging meetups or requesting help.

  • The booklets provided by the clinic were somewhat helpful, but were limited in their scope.

Do you have any wisdom for the next person undergoing this process?

  • Keep in touch with the community while you’re in Thailand. Make friends at the hotel. The girls are downstairs at the breakfast bar every morning. It’s a good way to meet people and hear stories about recovery. There was a very nice sorority group feel at the clinic and the hotel.

  • The lottery system sucks so much. Unlike most surgeons, due to the high demand and limited availability for surgery dates, the clinic is known for operating a provisional system where clients must wait until a new batch of dates is available, and must email the clinic as soon as these are available to reserve a spot. This may take several attempts over several months, and may lead to your surgery not being done until at least 18-24 months after you initially express interest. I had gotten lucky that they had Dr Prae on 2nd chance draw. Others might not be. Despite my positive experience with the clinic, this was probably the most stressful part of the process, and had very nearly lead to me seeking my surgery elsewhere.

  • Try to look after yourself and your body in the lead up to surgery. The clinic recommends stopping all forms of smoking at least six months prior to surgery. This necessitated a very intense abstaining from nicotine and cannabis in 2024, weight loss and fitness. These all contributed to making my recovery as quick as it could be, and my surgeon noted that I had very good wound healing in spite of the amount of pain I was in.

  • Try to relax as much as you can after your surgery. A lot easier said than done, but there’s a lot of unknowns going into surgery. I particularly had done the most research I could handle mentally, leading up to the surgery, and when I finally had it, I was still unprepared for what happened next. The pain and suffering was real, but the thing that almost killed me was the mental and emotional trauma suffered during the recovery, the numerous fights I had with my partner, the sleepless nights and the feelings of helplessness at my limited mobility. It was the first (and so far, only) time I’ve ever had to call Lifeline to talk myself down from my suicidal tendencies, and that was just 1.5 weeks after surgery.

  • If you can, bring someone with you that you trust completely and who is kind, patient and understanding. Whilst it is entirely possible to go through this experience alone, having someone with you who is able-bodied and able to look after you will make your experience significantly better. However, it’s important that this is someone you can trust, as they will be with you for a significant portion of your time in Thailand. You may be sharing the hotel room and hospital suite with them for an extended period of time, and this, along with the complications of recovery, will test your relationship with them. Me and my partner had a lot of tense disagreements with each other that made the stress of dealing with recovery a lot more stressful.

  • Everyone who goes through Suporn will tell you that there is a shit period from about 2-3 months up until 6-8 months post op, that the clinic calls “the difficult period”. This is when most of your sensation comes back, the wounds have closed up, and you’re now battling against scar contraction. I did not escape this. Your dilations will take longer and may occupy a significant portion of your day. My TTDs (time to depth) went from about 10 minutes to upwards of 45 minutes at times. I also ended up sacrificing about 1-2cm of post-op depth just to maintain my sanity (still very happy with my depth anyway, but sometimes I miss that 16th centimetre…). Sticking to the 3 a day schedule really helped keep the post-op depth and dilations at a manageable difficulty, and I was able to move down to twice a day after month 4. After about 6 or 7 months, I was able to move down to once a day dilations.

  • It will get better. In the moment, coked up on pain killers, antibiotics, sleeping pills, bleeding, using ice packs, hobbling around like you just escaped a nursing home, stuffing medical grade dildos inside yourself, screaming in pain, sleepless nights, it will be a shit time. Be patient and kind to yourself. Your body will heal. Your life will get better. The crash landing into your new womanhood will be rough, but it won’t last forever. After 6 months, I was able to get back into the pool, do 1000 metre swims, leg press 120 kilos and walk long distances unaided. You’ll even catch yourself wondering where your old bits went from time to time, like when you’re lying down on the floor, or when you accidentally go to tuck them in when you’re using the toilet.

Are there any regrets you have?

  • I wish I came better prepared. It seemed like there was a lot I didn’t know about going into surgery that I wish I did, that I wasn’t prepared to learn for the sake of my own mental health, as I was worried the more I’d read into people’s experiences, the more I’d want to pull out.

  • Sometimes I do wish that I’d maybe spent more time trying to work on my mental health and body dysmorphia issues, and that maybe if I did, I wouldn’t need to pursue expensive surgery just to alleviate those concerns. SRS feels like such a nuclear/molotov cocktail solution to a very nuanced problem, and part of me feels like this was the solution I wanted, but not the one I needed. The nature of gender-affirming surgeries is that they are incredibly expensive and risky, require ongoing maintenance to ensure continued physical health, and I feel like they divide the trans community between those who have the means to erase their gender dysphoria through surgery, and those who are forced to live with what they have. I consider myself incredibly lucky and fortunate that I even had the means to pursue surgery in the first place, and I couldn’t have done so if it weren’t for the support of my friends, family and partners at the time.

A visual representation of Rk’s mobility improvement throughout recovery

Rk's mobility improvement through recovery Rk's mobility improvement through recovery

1^1 “Dynamic dilation is as described in A Butterfly’s Journey (pages 164-165). It is a method where you push and stir the dilator to massage the scar tissue whilst at depth. The clinic says that it’s main purpose is to soften the scar tissue and open the vaginal canal width.”