That community of understanding should ideally include your surgeon, too. Or if this was normal, again, why had nobody ever warned me about how it would feel? In 2015, I contracted pleurisy inflammation of chest tissue as a side effect of frequent binding. These protocols are crucial, and most insurance providers do follow them. Wake up to the day's most important news. Top surgery is exactly what I need, and I will never regret working to fulfill my needs and striving for wholeness. Demchuu 6 min. I was terrified I wasnt healing properly. Many other members of the forum came out of the woodwork to agree. I would later learn the stipulations are largely the same with or without insurance (meaning, if one pays for top surgery out of pocket, the surgeon will also ask that certain prerequisites to be met). I posted on the ftm reddit about feeling a strange sense of grief at the surgery, and asked if anyone felt the same. I was expecting to savor the moment when I finally got to look down at myself and see my chest, for the first time, finally the way I knew in my heart it should look. Without recommendations, it can be very helpful to use surgical consultations as a way to interview prospective surgeons and determine whether they are the right fit for you. Id initially opted for sans-insurance top surgery under the assumption that hormone therapy was required. [1,2] Primary care settings may offer a Edit: I deleted a line joking that I would be playing Tennis 2 weeks after top surgery. I'm so sorry that you have to fight this fight, and I wish you all the best in life. I sought to embrace the changes that came with puberty and tried to become like the women I looked up to, but it required suppressing who I am in favor of pretending to be a woman. 2023 BuzzFeed, Inc. All rights reserved. Dr. Daniel Medalie, an experienced Top Surgery surgeon in Ohio, does not offer a NAC-free Top Surgery. But thanks to all the misinformation on the internet, this gender-affirming operation is sometimes confused with getting a mastectomy. Like a lot of health-related transgender issues, there is not enough information on how often individuals report post-surgery regret, though stories are becoming more and more common.However, some doctors have reported that patients are returning to them in the months or years following their surgeries, asking to have as much reversed as possible. It [is less likely to] form scar tissue. Many studies also confirm that trans people are happier and healthier when given access to healthcare, which usually means trans-inclusive doctors or gaining access to hormones or to surgery. It was freedom from binding, it was the first step to truly, powerfully reshaping my body with my own will. The result isn't just binder-free living. What I needed now was a definitive answer from my insurance company. I also don't experience much dysphoria about my chest unless someone talks about them or I have to buy bras. It was probably the first time I could honestly say I felt really good. In 2015, my partner gave me a greeting card that I still treasure that said, Happy birthday to my wonderful boyfriend. And during the summer of 2018, I was getting ready to experience another of those big moments: seeing my new chest for the first time after undergoing top surgery. But the morning after my surgery, when my surgeon came back to the hospital to take my bandages off for the first time and do the grand reveal, it wasnt really the memorable moment I was expecting. 4 years later, Ive grown older, wiser, and way more cautious. For me, top surgery meant life in a body that felt right, at last. The scars hurt. From person to person, the post-op chest may appear similar, but it is unlikely to feel the same or (if inspecting closely) look identical. What does it mean to be yourself, now? I remember seven months after that when, for the first time, my mom used my chosen name and then four months after that, the first time I saw it printed on my drivers license. I learn something new every daydid not require 12 continuous months of hormone therapy to qualify for insurance coverage. And they all agree on one thing: hearing other from other non-binary people about their experiences with top surgery helped validate their own feelings and needs. Hormone Hangover. There was also the psychological fallout of having body parts missing. The office manager with whom I regularly communicated at a plastic surgeons clinic before Id opted to go with insurance, on the other hand, told me that, yes, most providers require: A minimum of one year on hormones, and depending on your particular plan they require either one or two behavioural health letters. Since I was not taking hormones, she added, my insurance will not cover any gender reassignment surgery.. My fantasies of what transition would do for me, the road map I had structured my future on, dissolved into meaninglessness. Thankfully, more health insurance plans are starting to pitch in for medical transition costs, and Im very fortunate that my surgery was covered by my insurance. . My top surgery was a long time coming. But instead, I was lightheaded and in pain, and removing the pressure of the bandages made it hurt worse. ahhh! Increasingly more nonbinary patients are obtaining better access for gender-affirming chest surgery (top surgery), representing an important subset of patients who undergo such surgery. And on top of all of that, if you end up reverting to a female gender identity, theres the entire collapse of your understanding of yourself to deal with. Adrian says that after their surgery, they "feel more comfortable in my body. Whatever I thought I was getting into, I had failed to contend with the fleshy reality. Mainly I miss having the option to be more fem or more masc. I wrote this in collaboration with Carol and Jamie, who contributed their post-op detransition experiences and wisdom. I will be a freer person. They want a prepubescent appearance or non-masculinized, even feminized appearance, with no nipple reconstruction," explains Jenq. Part of HuffPost Personal. This essay was influenced and inspired by Carey Callahans great essay about detransition. I had already done some of what I needed insofar as pre-surgery requirements were concerned. In fact, I hated taking them off even to change them it was new and weird and made me feel exposed in a way I had never experienced and could barely understand. Plus, Im the kind of person who keeps themself busy all the time, and spending most of my summer bedridden was a nerve-wracking prospect. I was squicked out by my own surgical sites, and the combination of physical discomfort and general, was brutal, emotionally. Its easy to think top surgery will fix your life in some magical way. From hair trends to relationship advice, our daily newsletter has everything you need to sound like a person whos on TikTok, even if you arent. How many 64-year-olds do you know who can make such a solid plastic surgery joke? But my supportive friends and the thought of finally being able to jump in the lake without constricting my unwanted chest were enough to keep me optimistic in the weeks leading up to the procedure. It's definitely an investment the surgery itself is fairly intrusive and if you have to pay out of pocket, it can cost easily over $10,000. Society puts a lot of pressure on trans people to know exactly what we want or else we're not valid, but really we're just people figuring it out as we go along too :), thank you! I was terrified I wasnt healing properly. If your chest size is small, you might be able to have surgery that spares your skin, nipple and areola. It helps a lot. In The Cancer Journals, Audre Lorde said that losing a breast (from a mastectomy for cancer) was as viscerally painful as losing her own mother. Each Zodiac Sign's Unique Personality Traits, Jennifer Lopez Got a New Hair Color, and It's Not the One I Expected, Your March 2023 Monthly Horoscope Predictions Are Here, The Joys of Getting Breast Reduction Surgery. "You want the expertise without being humiliated, so try to find someone who isn't an asshole," says Bowers. It is important to note that non-binary gender identities are not 'new identities' or new concepts and have been recognised throughout the world for a very long time. My mom has always been so accepting of me, once we got through the first few months of turmoil over losing her only daughter. Why didnt I run screaming away from the surgeons table? Especially the first year, especially the first six months. Part One: The Post-Surgery Bad Feelings, Expectations Vs. I am not transitioning. Contributors control their own work and posted freely to our site. Bowers believes that aesthetics are an intrinsic part of every procedure, from phalloplasty to episiotomy. If you have friends or acquaintances who you know have had top surgery or other gender-affirming treatments, ask them for recommendations. Its still your only life, and you still have to figure out how to survive. I felt like I might be crazy having this kind of reaction to the surgery. I layered sports bras and Spanx tank tops for a long time before finally learning (at the age of 30) that actual chest binders with claspsessentially sports bras with enough elasticity to stretch and flatten my chestwere available for purchase online. I was taken aback by the deep, serious loss I felt. I think Ive moved passed that feeling about top surgery by going off T. But while looking for a solution, I discovered fat transfer augmentation. I kept them wrapped so tight out of anxiety that I continued to get light-headed and in risk of fainting every time I took them off, which of course only exacerbated the issues I was having. Thats me! Except it wasnt my procedure. That isnt me. Transgender people face a lifetime of suffering, which is exacerbated by the traumas associated with living in a world that is invalidating, dismissive, and even dehumanizing. The procedure may involve these steps: The person receives . Thank you so much to Carol and Jamie! Much like how my gender identity has evolved over this span of time, so have my varied binding techniques. If you're a transgender or nonbinary patient whose gender dysphoria is exacerbated by the presence of breast or chest tissue, you might be contemplating your next move. The mental health benefits of top surgery, especially when performed by a knowledgeable, affirming doctor, are unquestionably positive. There are many types of top surgery you can get depending on your preferences and your current chest size. The next essay will be about physical and emotional healing, forgiveness, and reconstruction surgery. Quick recovery, back to normal in no time, really. There are a lot of good things that go with it, aside from the visual outcome.". I thought i had made a mistake when i realized i'm not a binary trans man. Even within the queer community, some people are always ready to claim that others arent trans enough.. "He had to have tattoos done. While the SOC does not separate transgender male from gender nonconforming/non-binary in the verbiage of its affirmation surgery criteria, it does say that those who do not wish to undergo hormone therapy arent required to. So, after a week or so spent mulling my options, I nixed my sans-insurance surgery plans and opted to go with insurance instead. If you had top surgery and youre taking the loss of your breasts really hard, Im sorry. Non-binary queer femme, health educator, and intersectional feminist. I mean, if the insurance reps dont know squat, then a plastic surgeons office manager can be just as unwittingly ignorant. Top surgery, a common term used in the trans community to describe a double mastectomy, is a common part of gender transition for transmasculine folks like myself. Ive been binding my chest since I was a teenwhich means for over 25 years. This time, I skipped the phrase subcutaneous double-breast mastectomy and opted, squeamishly, for the term sex-change operation. As before, the rep put me on hold because she was pretty sure there was a different script for the kind of benefits explanation my inquiry required. Cookie Notice We live in a society where trans people have to beg for respect. Sending you good vibes. But somehow, eventually, even after the most catastrophic of mistakes, life goes on. I fantasized feverishly about turning back the clock. first time putting my needs / wants first!! All but one of the articles focused exclusively on transgender men, but I am non-binary. Interestingly, knee replacement surgery has a dissatisfactory rate of 6-30%. There is, however, one dominant way to look cisgender that is, when ones gender aligns with their assigned sex. Everyone in my life told me that growing breasts defined femininity. I'm so sorry to hear this! Dr. Sidhbh Gallagher's . Ive lived as both genders, neither fit me, so Id say I have enough experience to be able to call myself nonbinary. Nothing happens overnight. . "Gender euphoria" describes the moments when you realize for the . Of course I knew in an intellectual way, it was going to be tough to have surgery. An appeal is worth engaging in if the initial claim is denied. We live in a society where trans people have to beg for respect. I told him that it's inappropriate to ask questions about people's bodies, let alone their genitals. Tosh said insurance can be hit or miss, but to remember that theres always an opportunity to appeal. Prolonged binding is akin to wearing a Victorian Era corset, and it has singlehandedly caused my chronic back pain. One terrifying day in 4th grade, my nipples started to bud. It's also important to do intensive research into insurance and other financial options for your top surgery. And I was adamant about not undergoing hormone therapy, which I assumed was a coverage requirement at the time. The gore and the pain and sadness were not what I had expected. We aim to break boundaries, think outside of binaries and build bridges within our communities and beyond. St. Louis Children's Hospital is seen Friday, Feb. 17, 2023, in St. Louis. When I am aware of my breasts when I jog, walk down stairs, or wash them, I have an intense, physical reaction. My trans friends swapped surgery stories about how much it sucked recovering and not being able to do things for yourself, but nobody ever, they felt in a genuine way. Top surgery, however, was an option: a dramatic reshaping of the chest that would help me to create an aesthetic more aligned with my desired gender expression or identity. Still, my personal experience has been an exercise in patience, financial acumen and self-advocating. I persisted in spite of the disheartening responses I kept getting, chiefly because my friend Tosh Provancher would not stop saying, No, your insurance must cover the procedure. Tosh would know: Theyre non-binary and underwent top surgery. For anyone whos going through a gender transition, there are certain moments that stand out. I identify as non-binary because, well, Ive always considered myself non-binarythough I didnt know about the proper distinction in my youth. Even better, she would come to me. It may take some extra time and it may even mean a lengthy appeals process, but top surgery is worth the fight. I wanted it really bad. That was my go-to excuse whenever my secretthe breast bindingwas discovered: Oh, its nothing, Id respond as casually as possible. One study of 14 postsurgical youth (nine of whom were under 18 years) found that "all reported high aesthetic satisfaction and most self-reported low complication rates and improvement in mood . Even when I was feeling at my worst, I didnt actually think that I had made the wrong decision or that I would regret having the surgery. McTernan M, Yokoo K, Tong W. Ann Plast Surg. I was given a lot of clinical facts about what it would be like how long to expect to be bedridden, how to keep the surgical site clean, what arm motions could damage the stitches as well as what a. of all the dysphoria that my chest caused me. Its a huge step on your transition journey. The only problem: I knew very little about the process of getting top surgery. Dont you feel great, now that youve finally had your surgery? I felt like if I told them how difficult of a time I was having, Id be undermining my identity as a trans person. The morning after my surgery, when my surgeon came back to the hospital to take my bandages off for the first time and do the grand reveal, it wasnt really the memorable moment I was expecting.. Secondly, my desire for top surgery comes from me, not from the transgender community. It got worse after I realized I needed to detransition and make peace with my body, because that also involved accepting that my natural body would never be restored. Top surgery a gender-affirmation surgery with diverse options that can give people a gender-neutral or masculinely-contoured chest isnt something all transmasculine people need or even want. I remember the moment five years ago when I decided to change my name to Jamey, to be consistent with my gender identity. Why I Didnt Tell My Doctor Im Trans Before My Abortion, Your Guide to Chest Binding Properly and Safely, What It's Like to Be Transgender and Have Body Dysmorphia. The doctor performing the procedure, she recalls, did not listen to her boyfriend's goals and assumed that his surgery was a cancer treatment and went the mastectomy route. Instead, it is just assumed that someone is trans and trying to get that person to be happy with who they are is considered conversion therapy. During our brief pre-op consultation, my surgeon said that this was an easy surgery. Top Surgery Regret. When doctors don't really understand that you want to live as a male, they don't take the subcutaneous tissue away. This type of surgery accomplishes three things: changing the shape and size of the chest's skin envelope, altering the location of the nipple or areola, and removing breast tissue. Mr Ioannis Ntanos and Miss Chloe Wright discuss the ethics and health policy around top surgery for trans and non-binary individuals. Insurance can be hit or miss and really depends on your policy and your insurance carrier. The Standards of Care (SOC) are recommended clinical protocols set forth by The World Professional Association for Transgender Health (WPATH) for healthcare professionals to follow during their treatment of transsexual, transgender and gender nonconforming patients). I tried to be excited about them, dress them up, and take care of them. While detransitioning is different from transitioning, they share the feature of reckoning with the nature of your life and identity. Chinnapong/Shutterstock. View resources for our Top Surgery 101 event with one of the leading gender affirming surgeons in the country, Dr. Scott Mosser (he/him). Three months into my sans-insurance endeavour, however, I realized the full financial gut-punch I was facing: About $8,000 USD for the surgery alone, not including anesthesia and pre-operative requirements (which included, for me, an echocardiogram, an EKG, and a complete blood count paneleach of which meant separate medical bills). This piece is part of In Transit, our series exploring the ins and outs of transitioning and how trans and nonbinary people define it for themselves. "Having a clear communication and understanding about what its going to look like will optimally alleviate the dysphoria, in terms of the surgical goals. It is vital for surgeons to explain the procedure's limitations, such as how skin lines will come together without dog ears or excessive tissue left behind in the armpit. The anonymous 27-year-old tells Bustle that "As a person of color, it was really important to me to find a surgeon that was also a person of color" because they needed to be able to trust that their surgeon understood their skin care, their potential scarring patterns, and their experiences as a non-binary person of color. Keep in mind: Not all surgeons will do this. And for trans or nonbinary kids under 18, the road can be even longer. Im neither. Thank you again for this essay series. Secondly, my desire for top surgery comes from me, not from the transgender community. so I'm excited and nervous and I'm trying to keep a good outlook! Can I get Non-binary top surgery ? By entering your email and clicking Sign Up, you're agreeing to let us send you customized marketing messages about us and our advertising partners. For many, supportive medical care is part of that experience. I fixated on it as the quasi-religious ceremony of my becoming. Theyre also a licensed clinical marriage and family therapist, who regularly writes informed consent letters for clients, which are letters of recommendation for gender affirmation surgery on the basis of a gender dysphoria diagnosis; almost all providers require at least one of these letters. As someone who had lived as a happy tomboy from toddlerhood on, I felt betrayed by my body. I remember seven months after that when, for the first time, my mom used my chosen name and then four months after. There are answers, and sometimes the folks who have them dont even know they have themsuch as the insurance reps. And more than the physical results, I wanted what it represented. Who are you after all this? Dr. Amir Dorafshar. In the days and weeks following the surgery, I thought about that conversation often, almost obsessively. But, as far as my insurance provider was concerned, I am undergoing a FTM procedure. I dont know why the gender nonconforming affirmation surgical designation doesnt exist, much like how gender nonconforming is a sort of afterthought even with WPATHs protocols. oh interesting i had never even thought about that. Im now in my late 30s. The 0.3% regret rate of our newest study is much smaller compared to other, more common surgeries. And almost immediately after the surgery, the dread of regret started to sink in. The rep confirmed one more time that my procedureTop surgery? I had no idea how bad it was going to be. You can get through this, and build a life. I knew I was lucky to have so many supportive people in my life, but it felt like everyone I talked to wanted to congratulate me and ask how I was doing. I said Id been injured. A mastectomy can be a part of top surgery, but not every top surgery is a full mastectomy. My binder was never tight enough for me. Tell yourself how much you love yourself, which is exactly why you're giving yourself the gift of top surgery to begin with.". I called my surgeons office (again) and was surprised to hear them suggest that I was experiencing a kind of phantom limb syndrome of sorts. Top surgery for transgender women and nonbinary people might involve placing breast implants or tissue expanders under chest tissue. And if you dont have a Tosh egging you on, let me be them for you. When I realized my mastectomy had been a mistake, I felt betrayed, disoriented, and confused. It makes me more neutral because Ive finally gotten some stuff off my chest. The quality of life of young transmasculine people dramatically improves after receiving top surgery a mastectomy procedure that removes breast tissue according to a study by Northwestern . Top surgery can feel like a necessity for many of us who experience a lot of gender dysphoria centered around our chests, both because of how it makes our bodies feel, and because of how it causes other people to perceive us. In fact, I had seen dozens of post-op photos of trans guys and nonbinary folks joyfully seeing their chest for the first time. Hi everyone. After my mastectomy, I felt sewn up, aching, ghastly. Tosh, of course, told me 92 times that it was not. Non-binary individuals may identify as genderqueer, agender (without gender), bigender, or more. I will be able to swim without anxiety about going out in public with visible breast tissue. I was imagining a transformative and spiritual experience when I went in for surgery. Reality, and Grief. You are also agreeing to our Terms of Service and Privacy Policy. With Double Incision Top Surgery, you can ask your surgeon to not perform the NAC reconstruction, resulting in a smooth, nipple-free chest. 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Live in a society where trans people have to figure out how to.. Life goes on moments when you realize for the contributed their post-op detransition experiences and wisdom know,! Daniel Medalie, an experienced top surgery under the assumption that hormone therapy to qualify for insurance coverage change. More time that my procedureTop surgery, Id respond as casually as possible you get... Knowledgeable, affirming doctor, are unquestionably positive life goes on and intersectional.... Taking the loss of your breasts really hard, Im sorry breasts really hard, Im sorry, gender-affirming... Breasts defined femininity fem or more masc ever warned me about how it would feel used my chosen and... Beg for respect regret rate of our newest study is much smaller compared to other, common... That hormone therapy, which I assumed was a definitive answer from my insurance company and youre taking loss! 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