cw: discussion of weight/bmi, brief mention of physical exam and discomfort from that
for reference: i am getting "simple release" meta with scrotoplasty and vaginectomy but no ul. it will be in 2 stages, first stage with be the release, scrotoplasty, and monsplasty, and second will be fat transfers to scrotum and cleaning up the sides a little. so essentially the "full package" but no ul. i just don't really care to have it done as standing to pee is not only not important to me but ill actually continue to sit to pee post op anyway so it just makes sense to leave it where it is
so he was very nice, i heard his bedside manner was good and it is. very pleasant to talk to. i came in pretty set on what i wanted besides ul. i said I wasn't really sure that i wanted it because i probably wont stp anyway (i just think sitting to pee makes more sense) and he said if thats the case then i shouldnt get it because thats where most complications happen which makes sense so im opting out. to be clear, that was a choice that i personally made for myself and i dont think he wouldve refused to do it if i wanted it done
he asked for my medical history, family history, all the typical stuff you get at an intake appointment with a new doctor. he asked how long ive been out as trans and how long ive been on testosterone, both have been a long time, and my history with gender affirming sugeries and surgeries in general. i said that in the past ive healed very well with surgeries and that my main concern is that i have a pain tolerance like nobodys business, and that has made it hard with past surgeries to gauge my limits. like my arms were fully mobile with no pain after getting my drains out for top surgery and i didnt feel the drains go out at all, and i didnt even take opioids because i didnt need them, for reference. he didnt seem too worried about that. he asked about support post op but my wife was at the consultation with me so that wasnt a long discussion
he did a physical exam of my anatomy. this was very uncomfortable for me due to bottom dysphoria and sexual trauma. i knew it was coming and that hed have to touch me but i still freaked out a bit but it didnt last for more than 30 seconds (it felt longer though). he asked if ive heard of a monsplasty and i said oh yeah, he said id benefit from one and i said i know and want it. i have a fatty mons and am just fat generally. from there we discussed how the surgery would go, he showed me some diagrams, he did say that he does monsplasty during the first stage which was what i wanted so thats good. he said he likes to do scrotoplasty in a way that patients dont typically need testicular implants because they can be irritating in a lot of ways. he said he does fat transfers instead, went on a bit of a tangent that he "loves making balls" and that theyre his favorite things to make with bottom surgery because theyre all so unique and that was pretty funny
he said that my bmi is a little higher than he generally prefers patients to be and said that if i lost some weight itd probably be better for aesthetics, as "with bigger bodied people there can be some hiding of the phallus", i said i didnt want to, and he said "ok" and that was it. he did mention that higher bmis can correlate with healing complications however i have healed very well from multiple surgeries at around this weight so that was also a short conversation. he doesnt seem to have a hard and fast bmi rule however i was not much heavier than his preferred bmi so that couldve just been because i was very close. i have been losing weight just on my own but its not a conscious effort on my part and I don't really want any major changes to my body right now besides getting a penis and am already a little distressed about losing enough weight that some of my boxers fit looser than they did so i dont really want to try to lose any because i want to be a fat guy and that's what im doing. he also said that with me not getting ul that if i ever wanted phallo it might be a bit more risky to get ul done there if i want to, and i said im pretty set on meta and he said "yeah you seem like you know what you want, i just want to lay out all the information"
i asked him how far out hes scheduling and he said hes booked for early next year but spring of next year was a very reasonable timeframe. i said id ideally have it in the summer due to school scheduling, and he said when i get my psych letter in (my psychiatrist is already writing it, i asked him to on my last appointment so it might already be written) then we can schedule from there. kaiser insurance is now referring patients to legacy for bottom surgery due to ohsu's extremely long wait times, so i was worried about insurance change from ohp to kaiser but am not anymore. i will have to see about insurance changing because its my wife insurance and i need to see if me losing ohp insurance is a "qualifying life event" to have me added to her insurance because i as her legal spouse would be losing my insurance, but im not sure, so if anyone else knows thatd be great (im assuming it would could as im her legal spouse but just lmk, she will also be checking), but that all sounds good, im very excited. hoping to schedule very soon