Yeah mm, I think my confusion is mostly due to a lack of this step in the process for cis females. I know a small handful of cis women my age who have had theirs done for personal reasons (not medical ones) and while they were encouraged to speak to a mental health professional before and after the procedure, it was never a requirement for them. For me, I don't see those parts and I wouldn't care if they were there. I haven't had a period in almost a year at this point. But I'm planning on bottom surgery with the works and it's all gotta come out because they won't be able to go back in if there are issues. Coupled with the fact that I hate kids, it seems like a win/win.
I'm sure the visit won't be awful. It's a very trans friendly clinic, and my friend who is a few steps ahead of me in the process said he had no issues getting any of his referrals from them. It just seems like a pointless step to me.
I'm looking at 2 surgeons for my meta - one does the hysto, one does not (he intends to but doesn't currently have anyone to do them). I think it'd be better for me to go ahead and have it done closer to home. They have a great unit here that does them the way you described (minimally invasive, low/no scarring), and I know my insurance will cover it with them. I think I'd appreciate the extra gap for healing too.