#52: Dr. Blair Peters on Advocating and Innovating with Authenticity

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Plastic surgery isn’t just about appearance—it’s about reinvention. For Dr. Blair Peters, that theme runs through every part of his story.

After coming out before medical school and finding his place within the queer and trans community, Dr. Peters saw firsthand the inequities in gender-affirming care. Patients traveling across continents for surgery, often with no idea who their surgeon was or how they’d get post-op care—it felt wrong. That’s when his mission became clear.

Today, gender-affirming surgeries like phalloplasty, vulvoplasty, vaginoplasty make up the majority of his practice. But that’s not where the innovation stops. His expertise in peripheral nerve surgery is now transforming care for cisgender patients too—addressing chronic pelvic pain, loss of orgasm, and other conditions that have long lived in the "black box" of genital health.

We discuss:

• The massive, all-consuming nature of gender-affirming surgery as a field
• The unique multi-disciplinary approach required
• His work creating a national fellowship registry for plastics training in gender-affirming care

Dr. Peters also opens up about the resistance he faced in becoming a pioneer:

• The stereotype that trans patients would be too high maintenance
• The internal debate about making an entire career out of being queer
• The real fear of becoming a public target in a national political firestorm

We cover the grim reality many gender-affirming surgeons now face:

• Death threats, doxxing, and needing police escorts
• Being secretly recorded at conferences, with videos landing on right-wing media
• The political machinery driving today’s anti-trans healthcare movement—how it started with trans athletes, moved to youth care, and now threatens adult care nationwide

Dr. Peters explains how state-level policies, executive orders, and forthcoming legislation have created chaos at institutions like his—leaving surgeons to navigate legal, ethical, and personal safety decisions on the fly, often unpaid and unprotected.

Yet through all of it, he continues to operate—literally and figuratively—at full capacity:

• Fielding political crisis calls from 6 am to 10 pm
• Taking urgent meetings between cases
• Consulting with institutional leadership and legal teams
• Wondering daily: Are we still safe to provide care?

We also dive into the joy and creativity that sustain him:

• Designing nerve reconstruction surgeries with sticky notes and sharpies
• Innovating individualized procedures for patients both trans and cisgender
• Finding peace in the OR, surrounded by blue gowns and bright lights
• Reinventing his practice to stay engaged and energized

Dr. Peters shares powerful reflections on visibility and authenticity in academic medicine:

• The exhaustion of assimilation
• The freedom of showing up as himself
• The real question: Is it professionalism… or forced conformity?

We close with a conversation about sustainability, boundaries, and the 30-year plan:

• Guardrails around time and energy
• The wide, interdepartmental future of peripheral nerve surgery
• The healing power of storytelling—both his own and his patients’
• His plans to one day write a book that blends memoir with patient narratives to build empathy in a time when it’s urgently needed

This is a conversation about surgery, identity, advocacy, and resilience. About holding space for others while fighting for your own right to belong.

Because at the end of the day, we’re all just humans trying our best to live our lives in a...