GRS Bottom Surgery in Tijuana (Draft)

GRS/SRS Bottom Surgery in Tijuana

Caveat emptor: this draft has been published ahead of us fully recovering from bottom surgery. The recovery is expected to be between three and six months. We’ll update this draft after we’re fully recovered with our final thoughts.

Introduction

We are a transgender woman from Toronto, Canada. In October 2025, we travelled to Tijuana, Mexico to receive gender reassignment surgery (GRS), sometimes referred to as “sex reassignment surgery (SRS).” The short version of this story is that we strongly recommend Dr. Ivan Aguilar of the Mexico Transgender Center for vaginoplasty. We of course can only speak to our experience receiving a shallow depth vaginoplasty, but if our experience generalizes I would recommend considering him for any MtF or MtNULL bottom surgery.

a quick note on the Mexico Transgender Center (MTC) and the Men’s Clinic

In this document, we’ll be referring to Dr. Aguilar’s practise as the Mexico Transgender Center (MTC). This practise appears to be a side-project of Dr. Aguilar’s and a partner plastic surgeon, Dr. Carlos Mendez Miranda. Dr. Aguilar’s main practise is called the “Men’s Clinic.” Any official letter head you receive might have either “Mexico Transgender Center” or “Men’s Clinic.”

Background

As a Canadian citizen in Ontario, we were eligible for funded surgery in Canada. However, we were in extreme pain due to complications of Hormone Replacement Therapy (HRT) and an injury in our penis that lead to nerve pain. Even though our surgery would have been free in Canada, we would have had to wait two more years for surgery after already waiting for two years prior. We made a health/economic decision that even a chance of resolving our extreme pain through bottom surgery was worth paying for instead of waiting two more years. I could write a whole n’other blog post on the unacceptable hurdles and wait times that transgender folks have to endure in Canada to get this often life-saving surgery.

Once we decided to go out-of-country for our surgery, we focused on Mexico due to its proximity and Thailand due to it’s premier status for transgender surgery. After learning that Dr. Aguilar training under Dr. Shlomo Raz (Los Angeles, USA), Dr. Jim Kim Hong (Seoul, Korea), and Dr. Guido Barbagli (Arezzo, Italy), it was clear that Dr. Aguilar is a committed, studious, and collaborative physician in the gender reconstructive surgery field, and we felt comfortable with him.

Booking the consultation

I booked my consultation with the MTC in early October 2024. The consultation costed USD$50, but the fee was later applied to the cost of the surgery. They missed the first consultation, but quickly rescheduled it for the next day. The consultation was a very quick call with Dr. Aguilar where we explained what we were looking for, a no/shallow depth vaginoplasty, and he explained the procedure. When we explained the pain and the desire to have the surgery as soon as possible, he made room for an appointment in later that month.

Preparations in Toronto

We were put in contact with a lot of folks who are part of Dr. Aguilar’s team. Their preferred means of communication is WhatsApp. The people we spoke with were all great:

There is also a patients WhatsApp group. We didn’t use this resource, but others may find it helpful.

Our preparation was a little hectic, but we chalk it up to getting the surgery in a short amount of time. MTC performs surgery in Tijuana and Guadalajara. Because we were getting our surgery on a tight timeline, we had to get our surgery in Tijuana.

MTC asked for a deposit of USD$1999. They take this payment over Zelle or international wire transfer. Because we have assets in the US, we were able to use Zelle. This was a bit of a hassle because our bank flagged this payment for potential fraud, and we had to have a lengthy conversation with them to (a) prove that we were us and (b) affirm that we were aware of the risks of such a large transfer.

MTC works with a recovery centre in Tijuana called “Zen and Health Recovery”. They also work with a recovery centre in Guadalajara. Z&HR charges ~USD$150 per night or ~USD$250 per night with a companion. Z&HR will asked for a ~USD$250 deposit over Zelle to reserve our spot. We highly recommend using the recovery centre. We’ll talk more about Z&HR later in this post.

We decided to fly into San Diego and take ground transportation into Tijuana. Z&HR offers a cross-boarder medical shuttle for USD$250, which covers both to and from the airport. Their medical shuttle has some kind of medical fast pass, which makes getting back into the US faster for return flight. You can also take a bus shuttle from San Diego airport into Tijuana and be picked up by ground transportation there to save some money or fly into Tijuana International Airport.

We booked a hotel for two days: one for the 24 hours before surgery, and one for our partner to stay in during our overnight stay at the hospital. We booked two weeks for our stay at Z&HR as was recommended to us.

a note on currency

All of the prices quoted to us were in US dollars. Because we have some assets in the US, it was fairly easy for us withdraw and pay in USD. We have not confirmed, but we expect that MTC does not accept Canadian dollars, so you may have to go through the hassle of exchanging currency before sending it. I do not think Z&HR accept Canadian dollars, so bring USD for payments thereat.

a note on languages

Dr. Aguilar and all of the staff I worked with ahead of flying to Mexico speak excellent English. The nurses, drivers, and other staff spoke a mix of varying levels of English. Be prepared to use something like Google Translate for more nuanced conversations. All of the staff were very appreciative of us using our limited Spanish when we could, and most are very happy to help with vocabulary if they can. Many nurses used Google Translate when discussing something important in detail.

Preparation in Tijuana

Before our flight we were in contact with the medical shuttle driver, Teresa. She was waiting close to the airport and picked us up right away. She drove an unmarked car and sent us pictures of her car and her license plate before arriving. She was incredibly sweet. Honestly, great motherly vibes. She told us all the places we should visit while in Tijuana.

Speaking of, we needed to do all of our tourist activities in the 24 hours before surgery. We were in recovery mode after the surgery, and the recovery centre will not want to let you leave the facility unless your doctor has cleared you to leave, depending on how your recovery is going.

We were required to arrive in Tijuana at least 24 hours before our surgery to have pre-surgery blood work. The phlebotomist came directly to our hotel work and charged ~USD$50. If you are over 40, you will also need to have a pre-surgery physical in Tijuana.

Surgery Day

We were required to be at the hospital by 8am. A driver picked us up from our hotel and drove us to the hospital. Dr. Aguilar uses one of a few hospitals in the area depending on availability. Most if not all of these hospitals are geared towards medical tourism and cosmetic surgery.

After dawning the hospital robes and having an IV inserted, an anesthesiologist resident and their attending physician came in, and asked the normal questions (e.g. making sure we fasted from food and water for 12 hours) and explained that we would be under general anaesthesia and have an epidural (pain nerve block).

After that Dr. Aguilar came in. His bedside manner is great. One question I wasn’t prepared for is whether we wanted a flat or puffy pussy. It would have been nice to know we were going to be asked that in advance, because we hadn’t given it any thought and felt on the spot. We picked a puffy pussy, and have so far been happy with the result.

We were then wheeled into surgery. As we were being wheeled in, someone (we’re not sure who) asked us if we wanted a clitoris. That was a little disconcerting, because we’d already established with Dr. Aguilar that we did. I’m not sure what that was all about, but it did make us fairly nervous going into surgery.

Like all surgeries we’ve had. They put the air tube around our nose, and we were out before we knew it. Something alarming is we woke up in the operating room at the end of surgery. At this point they were just cleaning the wound and finishing the sutures. There wasn’t any pain, but I’ve never had that happen in surgery before.

After the surgery, we met Dr. Robolloso. A doctor who attended the surgery and was to be our follow-up doctor for our recovery in Tijuana. He told us the surgery went well, except for some extra bleeding. This may have been due to some of the medications we were on. As far as I know it was not excessive and did not require a blood transfusion. Dr. Robolloso showed us a post-operative photo of our new vagina. That picture was the best it was going to look for a few week.

We spent the night at the hospital. The nurses only spoke a little English, so there was a lot of gesturing and Google Translate, but they were very competent and nice. We were fitted with a urethral catheter during surgery, and we were to keep it in for at least a week while the swelling went down. The catheter was uncomfortable at first, but it was nice not to have to get up in the middle of the night to pee. At the hospital, pain was managed via IV. I believe it was morphine, but I’m not sure. Once the IV was out, pain was managed with high dose ibuprofen. Mexican physicians rarely prescribe opioids, and that’s honestly for the best. The ibuprofen was more than enough to handle our pain. Our partner who travelled and stayed with us through this whole journey was able to visit us after surgery but had to sleep at the hotel that night.

Because we had a shallow depth vaginoplasty, they did not have to make an incision in the pelvic floor muscles. Additionally dilation was not required because there was nothing to dilate. As a result, we were up an walking (slowly) the evening after surgery. We were discharged to Z&HR after one night and did not require physical therapy. Our understanding is recovery from a full-depth vaginoplasty is much more intense, requiring two nights in the hospital, regular dilation starting shortly after surgery to prevent the neovaginal canal from healing shut, and physical therapy to regain the ability to walk.

Two Weeks at Zen & Health Recovery

After our overnight at the hospital we were discharged to Zen & Health Recovery. We were picked up by a driver and taken straight to the recovery centre. Madison followed from the hotel. Z&HR has very strict security. We forgot to tell the security guard we had a companion coming, which meant she had to uncomfortably wait outside for a few minutes until we came down and got her.

The room was nice and spacious with a “smart” TV with Netflix and Google Cast. It had an en-suite bathroom with hand rails and a shower with a chair. The facility is two stories and our room was on the second floor. They have a chair-lift for folks who cannot climb the stairs, but luckily we were able to negotiate them without any trouble.

Z&HR offers three meals a day. They accommodate any diet. They were able to accommodate our vegetarian diet no problem. We also receive two snacks a day: fruit, yogourt, smoothies, etc. The food is very healthy: lots of vegetables and fibre. Anaesthesia and morphine are constipates, so the fibre helps get things going.

We cannot stress enough how kind and accommodating the staff are. Admin, nurses, security, housecleaning, kitchen staff were all wonderful. All of the nurses spoke a least some English and were prepared with Google Translate if necessary. We felt very well taken care of. One thing to note is that there are extra services: coffee bar, extra snack bar, laundry service, manicures/pedicures, massages, etc. We really only took advantage of the laundry and coffee bar. These services were added to our bill as incidental charges. At the end of two weeks we racked up ~USD$100 which seamed reasonable. When we left we also left a very large tip. We just gave one tip to split amongst the staff. You also have the option of tipping individual staff.

We met a lot of great people who were also recovering from surgery. We were the only trans person recovering and the only Canadian too. Everyone else were Americans who received cosmetic surgery. It was interesting to note that the vast majority of other patients received excess skin removal. It seems like this is becoming more and more common with the advent of gastric sleeves and new peptide weight loss medications (e.g. Semaglutide). Their recovery seems much more intense than ours was. It was great getting to meet all of them, especially Christina from the San Francisco Bay Area. We talked about everything from religion, to trans treatment, to US politics, to medical tourism.

Care and Follow-ups at Z&HR

We were very surprised that Dr. Robolloso came to visit us at Z&HR approximately every three days. Other patients at the recovery centre either had no follow-ups or had to be driven to their doctor.

I won’t lie, my neovagina looked very rough for a few days. It was purple and brown and inflamed, and the stitches did not look like they were having a good time. We were reassured along the way that everything looked fine. The entire time we were there we had compression bandages. This was the worst part: not the compression itself, but the removal and reapplication of the bandages. We developed a minor rash from all the bandage tape. The catheter stayed in for about a week until the inflammation went down. Dr. Robolloso gave us a sublingual fast acting pain medicine right before the removal. It felt moderately painful and a little weird, but the pain went away quickly after the removal. About an hour later, we peed on our own for the first time with our neovagina. Dr. Robolloso said something interesting, that “it will be very messy.” We aren’t sure if this was post-op advice or if he was merely getting us ready to pee with a vagina for the rest of our life.

After the catheter came out, the most annoying part about peeing was that they had to remove the compression bandages before peeing and reapply them thereafter. The rest of the recovery was smooth sailing. After about a week, we opted to try to go off of the painkiller early. We still needed it occasionally for pain flare-ups, but by the ninth day, we were off of it completely.

After the tenth day, we were cleared by Dr. Robolloso to leave the facility for small excursions. We only went out once, to a local mall (which are called Plazas in Mexico), and had some fantastic Japanese-Mexican fusion. Just getting out and walking around was wonderful for our mood.

Discharge from Zen & Health Recovery

With our recovery going well ahead of schedule, we asked to be discharged two days early. This was to get home to help a loved one preparing to lose a family member and because we wanted to avoid the FAA airspace shutdown in the US due to the ongoing government shutdown.

We left the recovery centre with our last compression bandage. We were instructed wear it as long as we could, until we had to pee. After that we were to wear tight panties with a menstrual pad and disinfect the wound at least twice a day and after using the washroom.

We made sure to arrange a wheelchair at the airport all the way through our connects back home in Toronto. And… that it for now! We writing this 37,000 ft on an Aeroméxico flight home wearing yoga pants without a skirt for the first time in public.

Parting Thoughts

As we said in the introduction, we will withhold our final judgment until after everything has healed. In the meantime we will say that we started out this journey skeptical and scared. No amount of research and planning could assuage our anxiety that something was going to go wrong. That we might be getting scammed or even trafficked. But to the contrary, things turned out far better than we expected. We felt safe, respected, and well taken care of. We will always be grateful to our doctors, nurses, Z&HR staff, and our loving life partner Madison.

If you are considering getting bottom surgery, especially with MTC in Mexico, and you have questions not answers in this blog post, please drop me a line at apocryphalauthor AT gmail DOT com.