Transgender and gender-diverse (TGD) individuals have unique healthcare needs. In order to provide competent care, providers must be knowledgeable about the challenges and discrimination the TGD community faces while providing an inclusive and affirming healthcare environment. More specifically, providers should be familiar with the unique genitourinary healthcare concerns that are germane to the transformative process of a TGD individual. Pertinent topics include general reproductive and/or urinary care/maintenance and pelvic health maintenance and/or management of surgical complications after gender-affirming genital surgery (GAGS). We provide an overview of the principles of GAGS including presurgical requirements, surgical interventions, and common postoperative complications. This chapter is designed to provide a facial surgeon with baseline knowledge of the genitourinary considerations for the TGD patient. Its goal is to optimize the multidisciplinary care often required to meet the complex needs of TGD patients.