There are a number of steps involved in transgender surgery, which can vary depending on the individual's specific needs and goals. The first step is usually to consult with a qualified surgeon to discuss the options and to develop a plan. The next step is to begin hormone therapy, which can help to make the transition process smoother and more successful. After hormone therapy, the next step is typically to have surgery to remove the breasts, ovaries, and uterus (if applicable). Finally, many individuals also choose to have surgery to construct a new penis or vagina. The exact steps involved in transgender surgery will vary depending on the individual's specific goals and needs.