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SETTING UP THE CONSULT: Back in late September 2014 I contacted Crane’s office seeking information about phalloplasty, consulting with him, and what his wait times looked like.His office took about 3 business days to get back to me, which felt reasonable for someone just seeking information.Me: So what does your scheduling timeframe look like right now? As far as priorities go, sensation and urethral lengthening are neck and neck for me. Being able to have penetrative sex is an absolute must for me and so I’m worried that maybe ALT is able to maybe sustain an implant a little better than forearm, would you say that’s true? Me: *Touching my wrist* So this would be the base of the penis or the tip? Because we don’t take any muscle we just take skin and fat. Dr Crane: We don’t because 1.) it really jacks up the price of the surgery 2.) it requires a separate surgery 3.) we take a thick enough split-thickness skin graft that it’s our opinion (mine, the microsurgery team and the Buncke clinic) that it doesn’t actually help at all and just raises costs and requires more surgery.Dr Crane: November 2015 here in SF w/ Chen and myself, after that I will be booking the end of December 2015 or absolute latest January 2016 in Austin……. Dr Crane: The tip Me: So, sensation differences between forearm and thigh? Me: As far as functionality of the donor arm, I’m wondering long-term what the functioning is like. Me: So it seems like from what I’ve seen that maybe folks with a higher BMI have a bit more noticeable indentation on the donor arm from the graft – Would you say that it’s accurate to assume that since I have very little body fat my indentation might be less noticeable? So everywhere on your body you have skin, fat, muscle.My goal in say 40 years when I’m on my deathbed, I want to be able to look back and say: I helped to make it possible for a transgender person to never have to leave their state for healthcare. And it doesn’t have to be all “Brownstein & Crane’s”, I just want this access for the community and this is the only way I see that happening.I could stay here in SF and just hide away in a successful practice and never promote anything.Also, if one requires a penile implant that would be a separate surgery that would cost ,000 out of pocket.I did inquire about both RFF (Radial Forearm Flap) as well ALT (Anterior Lateral Thigh Flap) phalloplasty and was informed that the BMI cutoff for the ALT phalloplasty is 35.
Our office is willing to work with other insurance companies, but first we need to verify that your insurance company offers trans benefits and that if a lifetime maximum exists, that surgery will be covered. Crane is out of network with your insurance company, you will be required to pay the self pay surgeon’s fee up front prior to surgery and our office will submit for reimbursement with your insurance.” The Consult: I chose to do an in-person consultation because I felt like I wouldn’t be able to get clear answers on the best graft site by just speaking with him over the phone.I booked my consult in the beginning of October 2014 and my consult was the beginning of January 2015 – It was just a hair over a 3-month wait period.His office is located across the Golden Gate Bridge so I had to take a bus out of the city and then had under a 20 min walk to his office from the bus stop.I needed to look into the eyes of the guy who was going to potentially do this surgery that I’ve been needing since I was 7.So I arranged for a quick trip out to San Francisco (I live on the east coast) with only two nights stay in the area at a Youth Hostel to keep the costs low ( per night).