Op, the bruises thing highlights for me that this guy is odd.
Most people would barely notice, and if they did would probably ot comment, and if they did comment; it would probably only be conversation around his you got them, do you play a sport etc.
He sounds weirdly pernickety, and fixated on small things (I mean, bruises fade, they are temporary).
Most people don't see almonds genital appearance as a deal breaker. Occasionally a fes people do, but most don't. There are other overarching things that are more important - overall, the person's looks, personality, circumstances etc.
And most people, even if they did rate genital.appearance as a deal breaker, would not ask to see them ahead of sexual contact. They would just have the sexual contact and, if if really was totally off-putting or a deal breaker for them, would just not continue seeing the person, and probably make UK an excuse.
He's very "eccentric".
I would guess their may be some neuro divergence, manifesting in a very negative way, going on with him.
Did you say he's never been married or in a serious relationship by 40?
That's unusual for medics, they usually get into relationships with fellow medics in their 20s or so, and if they don't their prospects are so good with non medics that they're "high value" on the dating market and have a tonne of opportunities and generally settle with one of them.
He's an odd ball