some general advice for starting out with gender affirming surgery:
• do as much research as you can on your own. r/TransSurgeriesWiki is an excellent starting point.
• the first step is figuring out what you want. it's ok if all you have is a rough idea at first, you'll have plenty of time to figure out the specifics and plenty of chances to change your mind.
• the second step is figuring out who you want to do it. If you live in America, this is unfortunately dictated by which surgeons are in network with your insurance and which procedures your insurance covers.
• don't wait to make a consultation, even if you're still figuring things out. depending on who you go with, you could be waiting months or years for your consultation- that gives you plenty of time to do your research. and there's no shame in canceling your consultation if you find out it won't work out.
• schedule multiple consultations with a few different surgeons. this keeps your options open and could save you a lot of time- I made the mistake of waiting 18 months for a surgeon who ended up not working out for me.
• start thinking about accommodations and caretaking. surgery will put you out of commission for weeks or months and you'll need to find someone who's able to help you during that time. having this figured out will help out during your consultation.
• rely on your community. Discord is surprisingly useful for this- if you're on one of your local queer/trans servers, you should ask for advice. there are also servers dedicated exclusively to bottom surgery or to specific surgeons. these servers are typically set up to help you along every step of the process. (i'm in a few of these, DM me if you want an invite)
• some procedures require hair removal and some have BMI requirements. this is something to ask your surgeon about as early as possible because these things take time. the BMI requirement is unscientific and fatphobic, but doctors still use it anyway. if your BMI is above 35, you'll need to either lose weight or go out of your way to find a doctor who will accommodate that.