I have a few questions about Metoidioplasty.

Background about me:
I am 18 years old, live in Minneapolis, but will be attending college in New York this fall. I started T when I was 14 and had keyhole when I was 16, and I am planning to have a hysterectomy next summer (I'm seeing a surgeon in August). I live stealth (or will be once I start college, because there were people at my high school who new me before I transitioned).

Questions:
1. Does insurance cover meta? I have insurance from Medica Elect through my father's job. How can I find out if they will cover it?

2. If insurance doesn't cover it, how much does meta usually cost? I've looked into the surgery, but it's all a little confusing of the different procedures, but I want testicles, urethra rewiring (or whatever it's called) and removal of the vagina (if I don't get it done during the hysterectomy)

3. Are there any surgeons that are highly recommended? Are there any in Minneapolis, or the midwest that I should see? Does it really matter where I go for meta, or do results vary widely? How should I find surgeons?

4. Should I get a hysterectomy next year (covered by insurance), or wait and do it with meta? I also read somewhere that the vaginal tissue is sometimes used for the urethra, should I not remove it during the hysterectomy then (if it's an option)?

5. Is there anywhere I can go to get more information about meta? I've looked online, but I haven't found anything super extensive.

Any and all input is appreciated, thank you!

Quote from: JamesRoe73 on July 04, 2014, 05:14:54 PM
I have a few questions about Metoidioplasty.

Background about me:
I am 18 years old, live in Minneapolis, but will be attending college in New York this fall. I started T when I was 14 and had keyhole when I was 16, and I am planning to have a hysterectomy next summer (I'm seeing a surgeon in August). I live stealth (or will be once I start college, because there were people at my high school who new me before I transitioned).

Questions:
1. Does insurance cover meta? I have insurance from Medica Elect through my father's job. How can I find out if they will cover it?

2. If insurance doesn't cover it, how much does meta usually cost? I've looked into the surgery, but it's all a little confusing of the different procedures, but I want testicles, urethra rewiring (or whatever it's called) and removal of the vagina (if I don't get it done during the hysterectomy)

3. Are there any surgeons that are highly recommended? Are there any in Minneapolis, or the midwest that I should see? Does it really matter where I go for meta, or do results vary widely? How should I find surgeons?

4. Should I get a hysterectomy next year (covered by insurance), or wait and do it with meta? I also read somewhere that the vaginal tissue is sometimes used for the urethra, should I not remove it during the hysterectomy then (if it's an option)?

5. Is there anywhere I can go to get more information about meta? I've looked online, but I haven't found anything super extensive.

Any and all input is appreciated, thank you!

1. Medica has coverage for reassignment surgery but it's best to make sure the contract you're with doesn't exclude it.  https://www.medica.com/~/media/documents/provider/iiisur20.pdf The bigger problem is finding a surgeon who accepts Medica.

2. A lot (20-30k depending on who does it and the number of surgical "stages")

3. Park Nicollet or University of Minnesota Physicians can probably do hysto but there are no surgeons in MN who do bottom surgery (meta) for either gender (which is funny considering UMN student insurance covers reassignment...). Finding surgeons is mostly a matter of using the Googles (or the lazy way and look at surgery guides/yahoo groups/transbucket/susan's wiki). Davis in CA is a good surgeon in terms of less times under the knife (2 surgeries: one to do most of the work, another for testicular implants).

4. That would have to be a personal choice. Many surgeons don't do vaginectomy along with hysto because it takes a lot longer to recover from and typically isn't done on cis-women. The source of urethral tissue depends on the surgeon's pref. Vaginal mucosa is used a lot simply because it's there and in large quantities although there is risks with getting it for grafting.

5. https://www.susans.org/wiki/Metoidioplasty is the cliffs-notes version of the surgery. Complication notes are typical of any surgery (blood loss, infection, bruising, UTI, urethral stenosis, and numbness). Vaginectomy complications include blood loss, infection, urethral and or colon damage. Testicular implant complications can include localized infection and erosion of scrotal skin resulting on loss of the implant. Vaginectomy and the creation of the space for testicular implant tend to result in more post-op pain than hysto. Some day I need to refresh all the surgery articles.