How I Expanded Companion Services to Include Post-op Care for Trans Folks
by Court
Over the last year, I’ve had the honor of expanding my companion (a.k.a. doula) work to include post-op services for trans folks having gender-affirming surgeries. While I am still very new to this work, I’ve jumped in fully and am learning tons along the way. Each time I share about this service with a friend or colleague, I get the same response “Oh, I didn’t know this type of care existed, and it’s so important!”
What is Post-Op Companion Care?
As a full-spectrum companion, I feel equipped to walk alongside folks going through a wide range of life transitions and changes. As I have grown into my practice and into my own queerness and transness, this offering has felt like a really natural process. I cannot speak for other folks doing similar work or offer a firm scope of practice, but I can explain the ways I have been offering care for folks planning for and recovering from surgeries.
For most folks, I offer the following services:
Pre-op planning and support system mapping: I help clients explore layers of support they can access throughout their recovery process. This can include identifying which friends or family members can show up for in-home and/or virtual support and companionship, as well as potentially help with personal care and/or chores, creating a MealTrain or other plans to cover food needs, finding housing options (for folks traveling from out of town), thinking through comfort ideas/sensory needs, and so on. This can be a stand alone service, and it’s one I typically walk through with clients a month or so before their scheduled surgery.
In-home care: For folks who want or need in-home support during their recovery, I offer a wide range of supports depending on their unique needs including the following:
Companionship/processing
Company on walks
Light food prep
Light cleaning
Laundry
Errands such as grocery pick up
Wound care
Personal care/showering support
Transportation to and attendance at pre-op and/or post-op appointments
Medication reminders/scheduling
On-call nighttime support, as needed
Coordinating schedule with client, partner(s)/friends/family, if applicable, and any other care workers
Resources/referrals: From grocery store apps to acupuncturist names to restaurant suggestions to sourcing bandages or other recovery supplies, I am happy to jump in and help find what they need before and during their recovery. This is especially helpful for folks who are traveling for their surgeries!
Note: As with many surgeries, the wound care and personal care instructions provided by the surgeon are for any caregiver. They do not require clinical or nursing training (although it wouldn’t hurt!). Tbh, this work is in a “gray area,” but I am sure most birth workers who are oriented towards Reproductive Justice understand this in deep ways. Much of what we do and how we show up cannot be easily written into a scope of practice. That said, just as with other forms of companion (or doula) work, it’s important to know when to refer clients to their medical care providers and to support them in taking those steps as needed.
What are the Challenges?
Finding other folks who do this work (both near and far). Far away colleagues can be in my support system and help me problem-solve, brainstorm, and relate to my experiences as a post-op companion. However, I also need local connections, as I can’t do 7-days/week care for folks AND have to plan for unexpected situations (like illness, emergencies, births, etc.). Furthermore, I want folks to have options and want to have other care workers to refer to. Slowly but surely I am finding these folks in my local Austin area.
Scheduling with sustainability in mind. Again, some clients are traveling from out of town and have minimal IRL support systems in my local area. I have to be really careful about my own capacity and really tend to my boundaries
Clients’ support systems may be limited. Many folks are traveling for surgeries; thus, they don’t have their usual supports, which may include creature comforts, pets, local friends/family/community. Some folks prefer to or need to keep their trans identity private, so it may not be safe to ask for support through this recovery process. And there are countless other reasons why it may be challenging for folks going through surgery to lean on others. This means that I may be helpful clients navigate lots of layers of resources in order for them to have care and recovery plans in place.
What are the Joys?
Witnessing people experience their bodies in new, euphoric ways. It’s a gift to witness trans joy! Laughing and sometimes crying with folks as they experience their bodies in new and affirming ways is truly incredible. I feel so lucky to learn about what surgery means to clients and to cheer them on along the way.
Transformations can encourage reflection and processing. Clients spend lots of their days on the couch or in bed during recovery. They often spend time thinking, journaling, praying, or reflecting in between reading or binging TV shows. I feel so honored to get to listen and receive folks’ stories!
Community is everything! Clients share about the ways they are getting/giving support from FB groups or reddit. Recently, two clients I was supporting met one another online and realized that they were both working with me; that connection delighted me! I’ve been able to pass along extra recovery supplies from one client to another, and if needed, I can reach out to my local queer and trans support groups for resources or materials folks from out of town need. It feels so good to experience the richness and generosity of community and connection like this!
Showing Up for Trans Folks
There are lots of ways to show up for trans folks who are having surgery whether you are a doula or not. This can range from helping organize a MealTrain or crowdfunding campaign, to offering daily memes via text, to helping coordinate care and/or find a doula, to attending appointments, and so on.
If you’re a doula who is ready to make your practice queer and trans-affirming, check out BADT’s Prerecorded Queer & Trans Reproductive Support CE Course. While this continuing education course is focused on supporting queer and trans folks through the childbearing years, it is a good primer for anyone looking to grow their queer and trans-competency.
Bio: Courtney or “Court” (they/them) is a witness, space-holder, supporter, and caregiver for families of all types and in all stages. They have served youth and their families since 2008. Court is passionate about honoring life’s transitions, and they believe that all birthing people deserve compassionate, steady, and informed support throughout their unique reproductive journeys. Court works with a wide range of clients, including folks who identify as highly sensitive, queer, trans, polyam, teens or young parents, and fellow caregivers. As a full-spectrum companion, Court is proud to elevate the voices and needs of each client they have the honor of serving. They are dedicated to inclusive, anti-oppressive work both in their personal and professional relationships and in the systems they live and work in. Outside of birth and coaching work, Court loves spending time with family, friends, and their cats. They can often be found swimming or walking, scrolling TikTok, or writing.