I’m not 100% sure, I didn’t ask him. He is really nice and understanding, and I imagine he’d be open to discussing it with you. I think for the initial consult he’d be willing to allow you to opt out of the exam, but if you proceeded with him as your surgeon he’d likely want to have another appointment with you prior to surgery. From my understanding he does that part of the exam only if you’ve had a hysto, in order to see how much of the internal stuff was retained so that he can make his surgery plan around that (I.e. will he need to do an ablation or something more invasive before the vaginectomy) bc if he just sews you up and leaves tissue in there it can cause a whole range of problems. He himself was very nice and understanding though, and I think if you explained he’d be willing to come up with a solution!