The comprehensive patient resource that didn't exist—until now.

I wrote the book I couldn't find.

When I was preparing for nulloplasty, I searched everywhere for a comprehensive guide. I found Reddit threads with outdated information. Scattered blog posts. Clinical brochures written for doctors, not patients. Discord servers where you had to ask the same questions everyone else had already asked.

The resource I needed didn't exist.

So I spent two years creating it.

40 chapters. 900+ pages. 12 countries. Everything you need to know.

What Makes This Book Unprecedented

The Only Book About Nulloplasty Ever Written

Not the first. The only.

The First Comprehensive Patient-Written Guide to Gender-Affirming Bottom Surgery

Every other book is written about us by doctors observing patients.

This one is written for us—by someone who personally went through the process.

What exists now:

• Dr. Linda Gromko's medical overview (doctor perspective, broad strokes)
• Edward Whelan's confirmation surgery guide (224 pages, no nulloplasty, minimal recovery depth)
• Finlay Games' memoir (240 pages)
• Juliet Jacques' personal story (memoir, not a guide)

What didn't exist until now:

• First-person patient narrative across the complete arc
• Decision → insurance → surgeon selection → preparation → surgery → recovery → complications → long-term thriving
• 1000+ pages of structured guidance woven with lived experience
• Coverage of every major procedure with real patient perspective

The Only Book Documenting Serious Complications From the Inside

Clinical literature discusses complications in third-person statistics. Existing memoirs don't report major complications. This book tells the truth about what happens when things go wrong. And why I would still do it all over again.

🚨 THE PROBLEM YOU'RE FACING

Right now, preparing for gender-affirming surgery means:

❌ Spending 50+ hours searching Reddit, Discord, and random blogs

❌ Piecing together fragments from dozens of sources

❌ Outdated information you can't verify

❌ Conflicting advice with no way to evaluate accuracy

❌ Missing crucial preparation steps because no one told you

❌ Expensive mistakes that could have been prevented

⚠️ THE STAKES ARE TOO HIGH FOR BAD INFORMATION

This isn't a minor purchase. Gender-affirming surgery is:

💰 $20,000 to $150,000+ out of pocket

🗓️ Months to years of recovery

🔒 Permanent changes to your body

✨ Life-changing in the best possible way — if you do it right

One wrong surgeon choice = $30,000 revision surgery.

One missed insurance requirement = denied coverage.

One skipped preparation step = preventable complications.

You deserve complete, organized, reliable information.

📚 WHAT'S INSIDE

Volume 1: Preparation, Procedures, and Recovery (Chapters 1–25)

Part 1: Understanding Yourself

Chapter 1: My Journey

Chapter 2: Understanding Dysphoria

Chapter 3: Debunking Myths

Chapter 4: Body Parts ≠ Identity

Part 2: Preparing for Surgery

Chapter 5: HRT Foundations

Chapter 6: Surgical Options Overview

Chapter 7: Financial & Insurance Navigation

Chapter 8: Legal Documentation

Chapter 9: Fertility Preservation

Chapter 10: Neurodivergence & Accessibility

Chapter 11: Finding Your Surgeon

Part 3: Ch. 12 - 22: Every Major Procedure—In Depth

Each procedure chapter covers: what it is (beyond medical jargon), who it's for, techniques and variations, realistic timelines, risks and complications (the full truth), recovery milestones, and the real considerations clinical materials won't tell you.

Part 4: Recovery and Life After

Chapter 23: Managing Dysphoria During Recovery

Chapter 24: Recovery Essentials for Patients

Chapter 25: Comprehensive Caregiver Guide The first published guide for the people who care for us. Practical skills, emotional support strategies, burnout prevention, and crisis resources.

Volume 2: Long-Term Living and International Access (Chapters 26–42)

Part 5: Life After Surgery

Chapter 26: Documenting Your Journey

Chapter 27: Physical Recovery and Relationships

Chapter 28: Thriving Long-Term

Part 6: International Access

Chapter 29: Framework for International Care

Chapter 30: Trans Healthcare Under Siege

Chapters 31–40: Country-Specific Guides

17 Practical Appendices

❓ Surgeon Questions

🏃 9-Week Surgery Sprint Plan

🩺 Caregiver Quick Reference

📄 Document Checklist

📈 Recovery Milestone Tracker

✈️ International Packing List

📨 Insurance Appeal Template

💊 Medication Tracker

Including 8 WPATH Therapy Letter Templates.

💰 THE WPATH TEMPLATES ALONE ARE WORTH THE PRICE

Many therapists and mental health providers are willing to write WPATH letters but have never done it. They don't know what to include, what language insurance companies expect, or what surgical practices require.

This creates problems:

• Multiple revision rounds as your provider figures out the format
• Letters that get rejected by insurance or surgical offices
• Extra sessions spent on "what should this say?" instead of actual care
• Delays measured in weeks or months

These templates solve that problem!

What they are:

• Complete, SOC-8 compliant letter frameworks your provider can reference when writing your letter.
• They include required elements, appropriate clinical language, and the specific justifications insurance companies and surgical practices look for.

What they're not: a way to skip the therapeutic relationship.

• Your provider still needs to evaluate you, establish a relationship, and write the letter themselves.
• These templates just ensure they get it right the first time.

Everything I wish that I had from the beginning.

Your investment: $49

👤 WHO WROTE THIS

I'm Axl Ibiza and go by @borgpup everywhere. I underwent nulloplasty in August 2024 at the Crane Center in San Francisco. When I started this journey, I had no roadmap. The information I needed was scattered across hundreds of sources.

I spent months researching, made mistakes that could have been prevented, and wished constantly for a single comprehensive resource.

Now I've written that resource.

My background:

🎓 BA with Comprehensive Honors, UW-Madison (Phi Beta Kappa)

📊 MBA in Finance, Johnson & Wales University

👨‍🍳 Former cook for James Beard Award-winning chefs

📜 ACF Certified Culinarian and Certified Pastry Culinarian (self-taught)

My trans health work:

⚕️ Nulloplasty recipient (August 2024)

🌐 Founder, bottomsurgery.info

🤝 Founder, community support group

🏗️ Built community infrastructure from the ground up

This isn't a blog post that got long.

This is what happens when someone with serious credentials decides the existing resources aren't good enough.

🔍 THE PERSPECTIVE NO SURGEON CAN HAVE

Surgeons can tell you what they do. They cannot tell you what it's like to be operated on.

They can explain techniques and outcomes. They cannot tell you what recovery actually feels like.

They have clinical expertise. They haven't lived with dysphoria.

This book comes from someone who has:

✅Lived with dysphoria for decades

✅Researched every major procedure exhaustively

✅Built community around surgical navigation

✅Actually undergone surgery and recovery

✅AND has the academic rigor to synthesize it all

This perspective is literally impossible for the medical profession to replicate.

🎯 WHO THIS BOOK IS FOR

If you're trans or nonbinary:

✅Considering surgery

✅Actively preparing for surgery

✅In recovery and want a comprehensive reference

If you're not trans but you care about someone who is:

✅Partners and spouses who want to understand and support

✅Parents who want to learn what their child is going through

✅Caregivers who'll be helping during recovery

✅Friends who want to show up without saying the wrong thing

✅Therapists and providers who serve trans clients

You don't have to be trans to need this book. You just have to care about someone who is.

💚 FOR ALLIES

Someone you love is considering surgery.

You have questions you're afraid to ask. You want to help but don't know how. You're Googling at 2am trying to understand.

For caregivers & partners: Chapter 23 is written specifically for you — what to expect, how to help, when to worry, when it's normal. Plus Appendix D: Caregiver Quick Reference Card.

For friends: Enough understanding to not say something stupid. Practical ways to show up. What NOT to ask.

The trans person in your life is navigating something enormous. This book helps you understand what they're going through.

🛒 GET THE BOOK

$49

One resource. Everything you need.

40 chapters. 900+ pages. 12 countries. 17 appendices. 8 WPATH templates.

Written by someone who's been through it.