I have an appointment booked with the mental health folks at the clinic I go to for HRT so that I can start working on bottom surgery referrals. My appointment is for next Friday and my doctor implied that if all went well, I would get a referral for my hysterectomy on the spot. She knows I want to have bottom surgery done sometime in the next year as well.

I guess I'm a little confused about needing a referral for the hysterectomy? Is it just for the sake of having it documented as a medical necessity for insurance? I'm 26, I have never wanted to have kids and don't intend on changing that. I can't really imagine what sort of conversation I'm going to have with a therapist about taking the plumbing out, and it's giving me anxiety. I don't want to come across as rude to her, but I really don't see a point in talking to her about it unless it's for insurance reasons. I don't want to get on her bad side since she's also the one who would be writing one of my bottom surgery referrals.

FTMAX, I understand your situation complete, I am similar 24 never want kids or use the parts ever.  Probably best to try and talk with the person and see what the real reason is for this visit.  Your dr may want to make sure you understand what you are doing by getting a hystero. I never want to never have another shark week or have to worry having problems with those parts that I don't want in the first place.  I hope you can get one that leave no or very small scars on the outside.  Also, I am seeing some bottom surgery dr offering hystero as part of the first procedure.

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.

great FTMax you have insurance to cover it, I don't have insurance now.  Good you have a trans friendly clinic to go too and not having a period of year must be great.  Good luck to you, hope you have a very successful meta procedure.