As mentioned above we ran into several restrictions because of advertising policies and therefore we changed strategy accordingly.
We were not able to advertise display ads and couldn’t use funnel principles for cold audiences, because we were not able to retarget transgender audiences in Google and also finding transgender audiences in Facebook was discrimentory.

So first of all we focused on Google search ads because only people searching for operations would be our main audience because they already have intent. So we did every keyword variation possible with every possible procedure and divided them into separate ad groups and campaigns with UTM’s so we were able to track every occurred click in GA. We started with broad keywords with a tone of exclusions and optimized each campaign, ad group, keyword and ad from time to time. Then we narrowed the search intent and optimized on high quality leads. On top of that to reach other markets outside English speaking ones we did ad translations to cover most spoken languages across the world/

Based on customers behaviour we understood that the Transgender community frequently uses Microsoft Edge, with this insight we tried Microsoft advertising ads which showed to have the highest conversion rate.

We reduced Brand Awareness and Engagement campaigns to zero, because of our main priority. What we did was optimize on inquires which we did by enabling several conversions actions: like chat clicks, 3+ minute duration on website, leaving the form submission. With the help of daily optimizations we were able to generate a huge deal of traffic.