not op, but i've won an appeal for top surgery as a UHC member. the insurance team (part of the surgeon's office that submitted the original PA) instructed me to make a really emotional case to insurance, talking about myself, my identity, and why surgery was crucial (in regards to dysphoria, lifestyle, etc). they literally told me to make it a sob story, and i mean hey, it worked. i had to fax the appeal myself (not sure if the team can do it on your behalf) and i think it took between 1-2 months to hear back, but that might just be my surgeon's insurance team not keeping me in the loop. it was a scary process, but in retrospect it wasn't too hard and didn't take too long. definitely do not rely on anyone but yourself in the appeal stage-- you have to advocate for your surgery if you wanna get it covered!