Top Surgery

Top Surgery, in t minus 2 weeks

The main reason I started this blog right now, as opposed to postponing it indefinitely, is because I’m scheduled for top surgery in t minus 2 weeks (not that T, this t). Actually, “2 weeks to go” was when I gathered up enough inertia to start writing, but as of today it’s more like t minus 10, very close to 9, days. I wish to document the process before and after (and the before part is diminishing quickly) in order to give back to those who did the same for me. Had it not been for the uncountably infinite blogs, forums, videos, sites, other internet locations, and even conferences, that I indefatigably digested for over a year, I would not be taking the plunge right now. My curiosities were sparked, my doubts were answered, my questions were quelled, and my nerves nudged enough not by my own inner monologue, but by those on the outside, sharing their inner monologues.

My dilemma is that I can’t begin at the beginning – who knows if that even exists, and if it did it would be too long for one cup of coffee. So, let’s begin at the now.

What the heck is top surgery anyway?

Top surgery, as it is typically called, is a double mastectomy (removal of the what’s its). To clarify, it’s also called FTM Chest Masculinization / Contourization. In short, it’s what female-bodied individuals do to achieve a male looking chest (just gave myself away there). There are several types of procedures, depending on your appendages’ size, but the most common one is the double incision, although I’m getting the T-anchor incision, which is similar. If you are not familiar with it, you can read more about it here, here, and here, or just ask me.

And you’re getting this? How do you feel?

That’s right, in about 10 days I will be travelling halfway across the US to the snow-pocalyptic midwest to undergo my very first surgery, voluntarily, willingly, excitedly, nervously. This is something I have been actively planning for about 6 months, and the day is almost here, hence the excitement. The nervousness comes from the fact that I’m just a nervous person, I need something to get nervous about, and this seems like an appropriate subject. Not to mention that I’ve never been in a hospital except once or twice to visit. I’m scared about the results, the recovery process (which I’ve heard is not so bad), and spending a week abroad cramped in a tiny hotel room. Moreover, there are other non-medical-related complications in my situation which I am unsure of how to deal with yet.

Complications? What complications?

Ah, now we’re getting to the meat of the issue (or the tofu of the issue, if you’re vegetarian). There are several important points here.

First, my parents know that I am transgender. They don’t get it, but they know. My dad is completely supportive, and is even coming along the trip all the way from his faraway place of residence. My mom took it much harder. We’ve been through a lot in terms of dealing with gay and trans issues (much much more on that later). So while my mother said she still loves me, when asked if she could ever look at my chest she said she’d rather not, among other things that were said when I told her. Again, more on this later, but the gist is that she’s not yet on board with all of this. I’m still going through with the surgery, and I planned it before even telling her, but it’s a thorn on my side to feel her unease.

Second, and most important complication, and one which I’ve rarely seen discussed in other places (and I’d really really like to read more about it), is that I’m neutrois. I’m transgender, but I’m not FTM, I’m FTN. Meaning I don’t identify as male. Most people that get this surgery already do identify as male; although I’ve heard of some people that don’t yet present as male, at least they are planning to. I… don’t know yet. I don’t identify as male right now, in any way; we live in a social binary world; I live in this world; therefore -> I still socially identify as female to the outside world. The only person I’ve met who had top surgery while still identifying as female was the first person I saw in real life who had had chest surgery, and after seeing this person I was completely convinced that’s what I wanted. Problem is, I don’t know this person, I only saw them once, briefly. After that I haven’t known, seen, or even read about anyone having top surgery and not identifying as male. So if you’re one of those, tell me! If not, let this serve as one fine example.

You’re not male-identified, but you’re getting an FTM surgery. How?

This goes to show to all those non-believers and continuous questioners [get on soabpox] – YOU DO NOT NEED TO IDENTIFY AS MALE TO HAVE TOP SURGERY – [get off soapbox]. You just have to go to an informed consent doctor, who will evaluate your sanity and seriousness in a few minutes and deem you ready for this life-changing operation. That and you have to give them money too… (to pay for the surgery silly!)

There’s so much more I want to know

Yes, yes, me too. But patience my young apprentice, is often rewarded. That, and I have to go to sleep.

44 thoughts on “Top Surgery

  1. I was SO excited to go back through the entries of your blog and see that you chronicled so much of your surgery. Because I’ve been wanting top surgery so bad since I found the word neutrois, and have been so confused about how it happens. I’ve read a lot about the actual surgery part, but not so much the whole “getting surgery” process.

    I had no idea that there were informed consent doctors. Actually, I couldn’t really figure out any of that part — whether I would need these mysterious “letters” people talk about, after seeing some therapists, or what.

    I don’t identify as male either. I don’t identify as female, obviously, but after surgery I don’t plan on presenting male to the outside world. I’m comfortable enough presenting female to people I don’t want to discuss my gender with (although it’ll be a lot more comfortable after surgery, for obvious reasons). Plus, I have no desire to go on HRT.

    1. Thanks for your excitement! Yes, that is the very reason I am documenting this: to dispel the myth, once and for all, that being male identified precludes top surgery. Once again, IT DOES NOT.

      I hope to expand discussion in this blog from top surgery to more neutrois territory, as top surgery is not the only thing on my mind all the time, but it has certainly been the centerpiece of the last month or so, and furthermore it is one of the more confusing (and daring/scary/real) topics surrounding trans and neutrois identity.

      (Also, feel free to email me for any specific/personal questions regarding this)

      1. Other neutrois topics would be interesting. Because I don’t even know what other neutrois topics could be. There’s so little written out there. I do want to write some more about it on my blog, too, if I can figure out how to articulate it.

        (Thank you very much! It is really amazing to have found such a friendly person who’s like me.)

  2. Other neutrois topics are definitely in the works. I already have a backlog of enough posts for two months, and I’m churning them out at a faster speed than would be wise to publish.

    PS: I’m glad you think I’m friendly, but I’m not. I’m mean. grrrrrrrrrrrr…… (that’s a growl, by the way, a very mean growl)

  3. I am a genderqueer Woman who is looking into top surgery. I too, have only known people that have identified as male to get the surgery. However, I am very clear that I have never and do not at this point in my life identify as male. I am androgynous, but not a man and yes I want my tits cut off. Thanks for standing on that soapbox, it’s a lonely one, glad I am not on it alone.

    1. Join the lonely soapbox my friend. If you have any questions about the surgery process or anything else just shoot me an email.

      1. Degressi has always been ahead of the curve, all the way back to Degrassi High. In that seires, two of the characters were identical twins. One of them gets pregnant. She actually has an abortion. This was back in 2005. (The episodes were edited for US broadcast.)An aside: could you possibly enable post and commment RSS feeds? I’d love to make it easier to see when you’ve posted something new. Thanks!

  4. I’m glad to have found this blog! There’s some great stuff here. As an MTN (also living in San Francisco, in Mission-Bernal – we’re practically neighbors!) I’ve been making some great steps towards my own transition and such lately – I’ve started facial laser hair removal, and have actually found a surgeon based in LA who is willing to do my lower surgery (funny how MTN and FTN have such symmetrical issues), although of course that’s MUCH more contentious and he requires a lot more than simple “informed consent.”

    Anyway, just saying hi. 🙂

    1. Hey Fluffy, nice to have you here, and discover we are neighbors! You should shoot me an email so we can meet up.

      Indeed, the amount of resources for MTN are even less than for FTN, but it sounds like you are on the right track. These days (especially in our area) there are more surgeons who are willing to do what you want, and not necessarily what is “required” in whichever guidelines. I’d really love to hear more about the process of arranging all this, and I’m sure there are lots of people who would benefit from knowing there’s someone out there like you, so let me know if you have a blog or if you’d like to be a guest author here someday. All the best!

      1. Sure, my blog is at although I don’t post there much anymore, and I tend to keep gender-angsty stuff friend-locked.

        One thing that’s been very helpful for me is finding a local therapist who is quite in-tune with gender issues (he’s a FTM himself, and while I’m his first MTN client he’s had quite a few FTN/FTAs so he was able to hit the ground running with me). I’d be happy to provide a referral by email, although I don’t think he wants me posting his information publicly (mostly because he’s already ultra-booked as it is).

  5. Hey, congrats on your surgery!
    I also recently got top surgery (a little over two weeks ago now). I identify as neutrois but I lied to the doctor and told him I was FTM because I didn’t want to chance him rejecting me for surgery. In the end, I chose not to get nipple grafts, because I don’t think they look good and I don’t have any desire to have nipples (I gave him a different reason, though). He allowed me to do that as long as I signed consent. Now that I’ve gotten the surgery, I have to remind myself that there’s no need to pretend I am FTM anymore when I go for followups.

    I had heard about a surgeon roughly in my area who has done top surgery on people who even identify as female (not even FTN or FTM), however I don’t think he’s as experienced with top surgery as the one I went to.

  6. How does one go about finding an informed consent doctor who would perform top-surgery without having to identify as FTM?

    I may consider top-surgery in the future.

    Thank you for chronicling your story, and sharing it. 🙂

    1. If you can find a surgeon who does top surgery normally, you could call in and ask if you need to be FTM in order to get the surgery, or if you just need consent. If they’re used to dealing with trans people, they should probably be at least open to hearing your situation.

    2. Thanks for stopping by, I really appreciate your comments!

      So to clarify, “Informed Consent” isn’t some status doctors have, it’s just the method they use to approve patients. You can find out by:
      – asking others about a particular surgeon and the requirements they had for surgery
      – browsing FTM and top surgery listserves, blogs, and the like, for specific surgeons and their requirements
      – and asking the surgeon!

      As Rai mentioned it above, this last one is my favorite. Sometimes (and this is happening more and more recently) a surgeon will be known to require a letter, or therapy, or be male identified, or hormones, or something, but if you email or call and point-blanc ASK, they’ll reconsider. One of the surgeons I emailed responded with these “requirements” and when I said it would be impossible for me to meet them, they loosely said we could go around them.

      This is especially possible with the new WPATH SOC (Standards of Care) 2011, which are now much more inclusive of genderqueer and non-binary people seeking transitions.

  7. I just wanted to give you a tip from a programmer 🙂 T minus 2 weeks means two weeks ago, not in two weeks. T plus 2 weeks would mean two weeks from now (T means the *current* time)

    I found this article to be very helpful, so thank you for taking the time to write and post it! =)

  8. You asked about someone who would get top surgery, but still identifies as female. I am such a one. I haven’t gotten the surgery yet, and unfortunately I probably won’t be able to, but when I bind I feel so much better about this fleshbag I occupy and if I could just be rid of my breasts entirely, I strongly feel that I would feel better about myself as a whole.

  9. Had TS Aug 28th in Florida (Dr. Garramone) it was my 50th Birthday gift to self. I’ll actually turn 50 on Thanksgiving Day 🙂 I am FTN, and have no desire to go on T. Loving my chest right now! Thanks for this blog, great info.

    1. Great to hear from another old fogie. I’m researching to get TS next spring when I’ll be 50. I’m not male but I’ve hate the boobs since they showed up when I was 11. Genetics have gifted me with good muscles so I don’t need T either.

      1. You sound a lot like me, I also have good muscle tone so not much contouring needed to be done. Thursday will make two months and my nip color is almost fully back with some sensation. Most importantly I am able to ride my bicycle, do yoga, and workout at the gym again 🙂 And I don’t miss them at all, it would be a great 50th gift to self. Good luck!

        1. I’m thinking of doing a major bike tour next fall. One of my concerns is how soon can I get back to cycling after surgery. I figure I probably couldn’t be pulling on handlebars for at least a month but maybe I could get on a stationary recumbent bike pretty quickly? How soon were you able to ride a normal bike? Thanks!

          1. You shouldn’t do any physical activity for 3-4 weeks, and absolutely nothing that uses your upper body (such as holding handlebars) for at least 4-6 weeks. Remember, it might look ok, but stuff is healing on the inside too.

          2. I have to agree with Micah, 3-4 weeks of straight recovery, waliking is good during this time (keeps circulation in tack) I walked my dog 1-2 miles every other day during this time. I just got back on my bike last week, rode about 7miles. I’m only using machines at the gym right now (easier to gauge ability) but I usually lift a lot of free weights. I expect it to take another month before I feel good lifting free weights and riding more than say 10 miles on my bike. Granted I live in the city (DC) so bumpy roads and weaving through traffic can take it’s toll after surgery.

          3. Thanks for the sharing the benefit of your experience. I’ll keep that in mind as I think about the scheduling I need to arrange.

    2. Congrats on surgery and your new chest! Even though the perception is only young people as non-binary, I’ve met a lot of older folks transitioning and defining their identity in their own way – many of whom have been marching to their own drum before most of us were born.

    3. hello, just reading through the blog and feel we may have a few thing in common. One being about the same age. My pre op appointment is for Jan.5th, I have no intention of taking T. I cant wait to be on the other side of this. This is also my gift to myself, I swore I would make it by 50. I’m 2 years ahead, something to be grateful about. I hope all goes well for you. And wold love to hear anything you may have to say- good or bad. Congratulations I;m thrilled for you.

      1. Hi Idgie,
        And congrats on your pending TS date! All I can say is try to stay calm the weeks and days leading up to surgery, I got my blood pressure all high with anxiety from just trying to get all my pre-op stuff done. Also, I can’t stress enough to just take it easy for 4-6 weeks post surgery. I am now three months post and the scar is still sensitive, especially after sleeping on my side. I slept on my back for the first month and gradually began laying on my sides for short periods. I used scar-away strips and mederma pm cream, my scar is quite thin and looking good. I’ll try posting a pic when I’m not so lazy 🙂 And of course surround yourself with positive loving people during the healing process. Yes I just celebrated my 50th Birthday on Thanksgiving Day, and I had a lot to be grateful for. I love the way my chest looks and feels now, especially in my t-shirts! Can’t wait for summer to roll around again, since my surgery was the end of August I only got to enjoy the t-shirt weather for a short while. Who are you having the surgery with? There are a lot of good Docs out there, I’m really pleased with Dr. Garromone’s work. Good luck, your date is just around the corner! Keep us posted

    4. Hey all. Idk if this blog is still active or not anymore, but I want to express deep gratitude.

      After years of feeling different (and probably being in denial) I’m coming to terms with being non-binary. Reading comments from so long ago, and especially from older folks, has given me a lot of joy and confidence that I am doing the right thing for myself. I kept thinking that if I ignored my feelings they would go away… Not the healthiest approach but I was scared, uninformed and felt alone. (Being in the midwest, even in 2022, can be hard)
      Got my first appointment for a gender therapist in December, have a few friends helping me try out different pronouns and I came out to my parents this week. It’s been both rough and beautiful. I don’t have all the answers. But I feel empowered and excited to figure them out. It’s ok to be complicated and confused, and I now really believe that for myself.

      Thanks to you all from before for lighting my way; giving me hope, courage and the knowledge that I am not alone, that there are more people like me out in the world than I have ever imagined.
      And to everyone after. You are valid. Your identity is real. You are one of many. You are not alone. You are not alone. You are not alone. ❤

      Keep pushing, we have and will make more spaces for people like us. Let’s keep making the world brighter and friendlier for everyone.

  10. I’m so happy to find this. Never knew how to identify i am going in for pre-op, top surgery on Jan.5th I’m beyond excited !!!! Just told my mother about it today. Rough, I’m 48 and consider this my gift to myself the one I have wanted since I was 10 yrs. old. I do not plan on changing my identity to male either. My biggest concern is that I have gained al lot of weight over the last few years due to depression of thinking I would never take this step. I’m so happy I wish I were going in right this minute. Glad to find this blog. It is the first time i’ve read a blog. Thank You!!!

  11. Hi, my name is Eli. I found your blog searching through Google and I was so excited to see that you said you didn’t identify as male. I am the same way. Well I have a mixed group of finds who call me she and he. But I’m female and have no problem being female. I just have seriously thought about top surgery. My point being that I didn’t think there was anyone else out there that was like this. And boo. Here you are. So I wanted to make myself known to you and let you know that I am glad I found another like me. 🙂 I have questions as well if you ever have time to answer. And of course for who ever sees this post as well.

    1. Welcome Eli!

      It is amazing for me that after 3 years this blog is still a beacon for people to find, since when I started I found nothing. There are many others who are going through a similar journey, I suggest checking out the commenters and visit their blogs too.

      Of course you can always email me with questions, I’m happy to answer.

  12. I’ve been looking for someone like me for years and i think you are someone that could help me with my question! I’ve never identified as neither male or female but some parts that looks more female to me are bothering me. I wanted to have the mastectomy but everyone keeps telling me that I can’t just be neutral. I have to be full FTM to have the right to the surgery. Anyway I would really like to talk about it with you to know how you felt after and what is it like today. Thanks 🙂

    1. Hi Lydia, I am the same, I generally identify as a cis women, but might be open to another space. I really want top surgery, been thinking about it for a long time now. I never understood the space I held, and didn’t think anybody else felt this way.

      Would love to chat if possible.

  13. I am so glad I found this. I am FTA (I use Agender rather than Neutrois. I have been desperate to get top surgery but I don’t identify as male. I’ve found one surgeon in the UK (where I live) who has done at least one non-binary surgery. I too am comfortable letting the public see me as female unless I feel it necessary to explain it to them. I can’t however deal with having breasts. Thank you for documenting your journey x

  14. I’m FTN too! This blog just brought tears to my eyes. Thanks for reminding me I’m not alone. I’d love to know more about your experience, now, 6 years later. I’ve been doing so much research and keep wanting to find more genderqueer folks with top surgery, Thanks for carving paths for us.

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