30-something trans woman here, 6 yrs on HRT.

I'm afraid to write. Folks have had good experiences with Dr. Rachel Bluebond-Langner at NYU and Dr. John Pang at Mt. Sinai. I don't want to burn bridges with Bluebond, since I may ask for minimal depth, but the consult was hurtful. I think Pang, Bella Avanessian (also at Sinai), and Bluebond have high likelihood of great results. I think Dr. Robert Oates at Boston Medical Center is very sus.

I'll go chronologically:

Boston Med Center -- March, 2017 -- Dr. Robert Oates

I was 1 yr, 5 mos on HRT, and the doorman greeted me with "sir." Hadn't heard that in months, and it stood out, esp in a place w/trans patients.

Oates works w/Dr. Jaromir Slama, as I understand it, but I only saw Oates. This is a paraphrase:

"...And we'll give you D-cup breasts at the same time as the vaginoplasty."

I said, "I actually don't want breast implants."

"Why?!"

"I just want whatever hormones gives me."

Him: "What woman doesn't want big breasts?!"

"I don't feel I need big breasts to be a woman."

"That's crazy! Every woman wants big breasts! Do you really want to be a woman?! Normally, we want to wait 2 years on hormones before implants, but I'd do it for you right now!"

This went on back and forth until he got up to leave. He told me I should think about what I want before contacting him, then handed me a card, "Just in case you change your mind." Then he took another couple steps and stopped at the door: "Oh, you can probably lose some weight too."

I'd been described as medium or medium-thin. I said, "But I'm well underneath the 30 BMI limit you stated."

He paused for several seconds, thinking, then looked be dead in the eye and said, "Couldn't hurt," smirking. He left.

For reference, I'm part Asian, and I feel like "big boobs" is an American standard I don't want to burden myself with, esp since my breasts are comparable to my Asian relatives'. There were things Oates said I don't quite remember, but the vibe he gave me was that he had a certain "look" that he wanted. It felt like he had some fetish, TBH.

New York University -- Drs. Rachel Bluebond-Langner & Lee Zhao

It took maybe 3 mos. to get from contacting folks to a consultation. I have an inflammatory disorder, but I take anti-inflammatory medication daily. I mentioned this in the patient portal, in a phone interview, in another phone interview, in a medical questionnaire online, and in the actual paper questionnaire at the hospital. I'm from out of state, so it cost my friend and I like $1200 for transportation, hotel, food, etc.

A young...nurse guy? Whatever he was, he came in, and I talked to him rapid-fire for over 30 minutes, maybe closer to 40. He said my inflammatory condition would be absolutely no issue at all. He actually was far more concerned that I may have anal scarring. But reassured me many multiples of times I'd have no issue with the inflammatory disorder, esp since I was medicated. He said both minimal and full-depth vaginoplasty was available, since I was trying to decide between them, and that I'd get surgery very soon. He left.

After a long time, the door creaked open. Bluebond peaked her head in, and in the shadow behind her was Lee Zhao. They didn't step all the way in; just held the door open to lean over.

"You have an inflammatory disorder that disqualifies you. There's nothing we can do."

They started closing the door immediately when my friend and I both panicked, shouting, "Wait!"

They finally both came into the room. Bluebond audibly huffed with a chest heave. My friend and I mentioned the previous nurse's comments, and Bluebond kept cutting us off before we could finish any sentence. I don't know if she even heard that I was medicated, because she kept talking over me loudly.

I don't remember exact quotes, but she then said something akin to, "There's nothing anyone can do. You can never have vaginoplasty. No surgeon can do this."

My friend spoke up and advocated for me. We were both trying to wrangle Drs. Bluebond-Langner and Zhao from constantly cutting us off and leaving.

I said, "I was actually thinking of minimal--"

Bluebond: "NO! You can't just decide on this on the spot because you can't get what you want!"

"No, I'm actually not into penetr--"

Bluebond: "This isn't something you can decide on just because you're emotional."

Under pressure, I tend to code switch into Asian stoicism super hard, so I was dumbfounded by this "emotional" accusation. I tried to say, "I'm a lesbian, and I was thinking of minimal depth anyway," but both kept talking over me, especially Bluebond-Langer, and she was extra loud. I don't know if they even heard or registered anything I was saying.

To Dr. Lee Zhao's credit, he looked very embarrassed and bashful, like the cartoon kid who's friends with a bully but doesn't want to be a bully himself. It was like a Hey! Arnold episode or something.

We kept asking if there was really no surgeon that could give me vaginoplasty, and Bluebond's answers went from "No surgeon" to ambiguous tirades, berating us for being "emotional." Finally, my friend persisted in her questioning and asked for the umpteenth time, and Bluebond finally said:

"Okay. Yes. Yes, there may be other surgeons that can do this for you. Just not me."

I asked, "So you're saying it's not impossible--that another surgeon could help?"

Her: "Yes, there may be another surgeon."

That just blew my mind. She really leaned in the door and said I could never have vaginoplasty ever , and really wanted me to keep believing that my whole life, never knowing I could have gotten help. Just seemed like typical "inflated doctor ego" that I've seen countless times (particularly since it took 10 years before someone diagnosed my inflammatory condition, and bc I started transition in the Bible belt of the U.S).

Mt. Sinai -- Dr. Pang

I was interested in Dr. Pang, because he seemed to have comparable results (aesthetically, sensory, and w/overall satisfaction) as Dr. Bella Avanessian.

Right after the debacle at NYU, I contacted Mt. Sinai. Over and over again. They kept giving me wrong numbers, transferring me to the wrong people, transferring me to each other, not getting back to me, etc. I had to call OVER and over.

Finally, I was told to wait for a call. I had to keep calling about that call. Then I was told to wait for another call. I had to keep calling about that call. It took maybe 7 mos. to get a coordinator, Rebecca (they/them), who kept telling me to wait for more calls. Finally, they set up a virtual appt. w/themself.

They told me because I had Medicare (which was free), I had to switch to a Medicare Advantage PPO (which costs money, monthly) to get covered for Dr. Pang. They said I could go to two other doctors, Drs. Purohit & Djordjevic, with regular Medicare, but I really wanted Dr. Pang. So I switched to a Medicare Advantage PPO via UnitedHealthCare and decided to pay like $50-$60/mo, if I remember correctly. Rebecca set a consultation to meet Dr. Pang.

By the 10-month mark, my friend and I had spent another $1200 or so--plus lost money due to my friend taking days off--to go to the consultation.

I went into a waiting room, then got called to see an in-house therapist. He was cool, and he had actually heard of my inflammatory disorder. He even taught me a couple things about it I didn't know, like which foods would be very harmful to me (I just so happened not to eat those foods, thankfully). He also was an ethnic minority and understood what I meant when I said my entire family disowned me for being multiracial and for transitioning. He was a tall guy with a mohawk, and he was baller.

After, I saw a nurse. She said, "This is so weird! You're not seeing Dr. Pang?!"

I was like, "Wutt."

"Normally for out-of-state patients, we schedule for you to see the surgeon the same day we do bloodwork. Someone must have scheduled you like an in-state patient. We streamline two appointments into one for out-of-state, because it costs them more time and money to see us."

I went into the aforementioned numbed-out stoicism and was like, "Oh, really, okay," really pleasantly. I don't really understand my own reactions, 'cause inwardly, I knew I was gonna lose it in the next couple days--just not right then.

The nurse did a lot of cis-splaining that was annoying afterwards, but because it's a distraction, I'll just write about it in the comments if anyone asks.

I was given no further instructions, so I called Rebecca, asking what to do. After some phone tag, they told me:

"Umm, actually Dr. Pang doesn't take any Medicare at all, not even Advantage."

I asked about Avanessian.

Rebecca: "Drs. Pang, Ting, and Avanessian just stopped taking your insurance. But...you can still see Drs. Purohit & Djordjevic..."

I was put on the hook by Mt. Sinai for 10 months. I changed from free insurance to a monthly one (with $10K deductibles for inpatient hospital stays) at Rebecca's instruction. In the end, I still can't see Drs. Pang nor Avanessian. And the suggestion is to consider the two surgeons that were already covered when everything was free.

Insurance Help? Surgeons? General Support?

Anyone know of any surgeons that would take UnitedHealthCare under Medicare Advantage PPO?

I see Dr. Min Jun takes UHC, but I don't know if that includes what I have. Does it?

Any general support or kind words? I'm really socially anxious, so please be gentle.