Criteria for Penile-Inversion Technique

Backstory: I asked my doctor to send the pre-authorization form for bottom surgery to OHIP, knowing they'd decline it because of the type of surgery.

They got back saying they are considering my application withdrawn until I get a surgeon who performs penile inversion vaginoplasty to assess that I am ineligible. So my doctor referred me to Women's College Hospital.
Women's College Hospital had some requirements for how much skin stretch is and the circumference of the penis. However, they don't say if these measurements are taken flaccid or erect. It would have to be flaccid right? I can't imagine a doctor would be able to take erect measurements. Or would they assume a certain value based on what they see? Sorry this has been confusing me.