Wait, are they talking about fisting? How the fuck can you not know that you are destroying your rectum doing that stuff? Anal is bad enough, but fisting -- what kind of degenerate would enjoy that, giving or receiving? Self-inflicted, no sympathy. And I'd be willing to bet that they didn't share the fisting info with the doc. That would probably have been a red flag for him to consider a prolapse situation. Or, he could really just be an asshole who always does the surgery no matter what so that he gets paid. But again, if troons could talk openly about problems with their SRS, these docs wouldn't get so many patients to screw up. So still self-inflicted, no sympathy.