The quality of surgeons does vary widely. Some require an original operation and multiple revisions to get it right. And some never construct all the proper parts of a woman’s anatomy. To be authentic, labia minora and majora need to be created along with a clitoral hood. The best ones almost never have a problem because they have skill. The premise of someone like Jessica Pin is that she can tell whether a woman is cis or trans based upon the phrenology of the vulva. This is utter nonsense. Even some cis women have unusual configurations to their labia. The point of my response was to say that to claim she could tell whether I was trans or cis by taking a cast of my vulva is ridiculous. She may have focused on a particular individual, but her claim is much broader than just one person or certain exceptions. She says she can tell all the time on any woman.