Heya. I'm a 16 y/o trans guy, hoping for advice? I'm getting top surg. in late July. I saw your post on you knew binding is unhealthy but did it anyway, it resonated a lot. The reason I want top surgery is because I HATE binding. I've been doing it for 4 years. I'm so, so sick of the pain, and the overheating, and the hiding. Also: I currently have multiple severely bruised ribs. Not fun. Do you think top surgery is the best option? (side note, its 100% covered by insurance. Debt is no issue)
Hi anon, sorry for the late reply. This is a complicated topic for me.
Itās hard to talk about. Iāve had to sit down and work on it in small chunks over the last week or so, but there is only so long I can dwell on it before getting too worked up, and there are better and happier things to do in life.Ā
I canāt tell if what Iāve written is of any use; it probably comes off too strongly. Might be TMI altogether. But Iāll go ahead and share it, because I suppose thatās better than saying nothing.Ā
Iām not sure what kind of advice youāre looking for, both because I donāt know you at all and because it sounds like you have your surgery scheduled and have made up your mind. I think only you can decide whatās best for you.
Rather than advice, I can only share my experiences and personal opinion. I assume thatās what you want, since youāre asking someone who regrets having had surgery.Ā
You ask if I think top surgery is the best option. The answer is a resounding No.
Iām not even talking about you or any specific person. Just in general, I think itās a bad idea.Ā
Surgery is intense, invasive, risky, painful, and traumatic. A mastectomy is a drastic measure to take, and yet, top surgery is casually talked about as if it were a fact of life, as natural as growing old.Ā
Whatās worse, I see little discussion about what it feels like to inhabit a post-op body. I went and looked through the tags as much as I could stand, and nothing seems to have changed since I started binding ~8 years ago. You get flooded with āhere is what I look like 1-year post-op!ā and āitās my first summer binder free!ā and āit feels like Iām finally in charge of my bodyā.Ā
Most of the focus is on visual appearance, identity affirmation, or on everything top surgery isnāt ā namely, how different it is from binding. Everyone loves uses the horrors of binding as justification for surgery, as proof that surgery is good and beneficial. I did the same thing; Iām just as guilty of it.Ā
But, I donāt see many people sharing post-op experiences like mine: permanent nerve damage, chronic pain, unnatural sensations, major revisions (I had to undergo surgery with full anesthesia twice, 1 year apart), etc. Not to mention uncomfortable experiences with the surgeons themselves. Maybe Iām just an unlucky outlier, but even if so, I donāt wish it on anyone else.Ā
In my consultations, I told my surgeon that I didnāt care about the visual result without a shirt ā I didnāt care about the fact that there would be scars. I just wanted to be able to finally stop binding. I wanted my chest to feel like it did before my breasts grew in. I didnāt want to feel breasts there anymore. I wanted it to feel natural. But the discussion was always steered back toward appearance, no matter who I talked to.Ā
Top surgery did not give me a body that feels natural to inhabit. Instead, it literally feels like my breasts have been cut away. It feels exactly like what it is.
With top surgery, tissue is still left on the upper portions of the chest, in order to make a ānatural looking contourā. That tissue still feels the same and is affected by gravity in the same ways as before. So, if I lie on my side or bend over (or exist in pretty much any state other than the āstand up straight, shoulders back, arms at your sidesā pose that they put you in for pre- and post-op photos), that tissue droops or jiggles or does whatever it did before, only now I can also feel where it cuts off and the rest of the breast tissue was scooped away. I can feel where I was cut, where disjoint pieces of skin were sewn next to each other, and where skin is now missing. I donāt know how else to describe it. Itās an unsettling, unpleasant, truly surreal combo of sensations. Itās a heavy weight every day, to physically remember that Iāve been cut into.Ā
The procedures my surgeon did left the nipples and their nerves intact, with the aim of retaining sensation (Though he did still cut the areola and nipple to a smaller size, despite my asking him not to. Again, goes back to his insistence and focus on a ānatural male appearanceā over my concerns about how I physically feel.) Unfortunately, nipple sensation is not like it used to be; there is only pain now. My nipples used to be a source of erogenous/sexual sensation, but now, it exclusively hurts for them to be touched in any way. Even light pressure is painful. Sometimes I wonder if I would have been better off had I lost them altogether.Ā
I get shooting nerve pain both in the nipples and in the surrounding tissue, even into my sides and armpits. The frequency of pain has decreased over the last 3 years, but not the intensity. When it hurts, it hurts bad. It sucks.
And to top it all off, I still get residual pains in my ribs from when I bound my chest, even after all these years of being āfree from the binderā, even though I followed all the rules to bind āsafelyā. Any given day, Iāll be going about my business when all of a sudden it feels like a knife is being wedged between my ribs.Ā
In some ways, top surgery has made me feel even worse about my body than I did before transitioning, especially since this is something I ādid to myselfā. I used to think accepting my body in its natural state was hard (in fact, I was convinced it was impossible and thus made surgery a necessity), but man, itās even harder to accept an altered state that I chose and enacted.Ā
I did the surgery stuff right: I shopped around and talked to multiple surgeons, I picked one with lots of experience and a decent reputation (the worst I heard was that heās a bit old-fashioned in attitude, but has a track record of good results); he even presents at the Trans Health Conference. I was in good health, didnāt smoke, wasnāt overweight; I followed my surgeonsā instructions to a T and didnāt rush during my recovery. Despite these things, it didnāt go well.Ā
Even before I detransitioned, when I still identified as male, I was disappointed and unhappy with the result. Having detransitioned puts the cherry on top of the I-Regret-This cake, but even if I hadnāt detransitioned, I would still be dissatisfied.Ā
I still remember the day the bandages first came off. I immediately knew something was wrong (and indeed, it turns out the surgeon did something different than agreed and Iād need a second surgery in a year), but even then, the close friend who accompanied me ooh-ed and ahh-ed atĀ āhow great it looks!ā. All responses from friends were positive, were all about how I looked. When I shared how miserable I felt, they didnāt know what to say. Sometimes theyād get straight up offended and insinuate that I was being invalidating in some way or another.
I went to all my post-op followups with my surgeon, and at my last appointment, something like a year or two later, I told him I was still feeling the nerve pains he told me typically go away after the first few months to a year. The most he could say was, āHuh. Thatās strange.ā Instead, he showed me the pre- and post-op photos. āThe before-picture looks like a hairy woman, and the after-picture looks like a hairy man! Itās a complete transformation!ā I just gave him a tired smile and nod. There was nothing more I could say, to him or to myself.
I wish I could go back in time and tell myself, āDonāt get surgery, it will feel worse. Just stop binding. Crazy idea, I know! But you can! Please just try; you can find a way! Literally anything is better than the road youāre on!ā Though if I really could go back, Iād go back several years further and make sure I never started binding in the first place, because thatās where things really started going downhill. But there is no going back, and there is no returning to what was.Ā
I canāt in good conscience call surgery a āgood ideaā when it has gone poorly for me. I truly donāt know what else to say. I donāt know what advice I can give. All I know to say is that it wasnāt worth it. Feeling flat wasnāt worth it. Fitting into button-downs wasnāt worth it. Feeling less-jiggly wasnāt worth it. Being slightly less noticeable to men wasnāt worth it. Because when Iām away from the eyes of others, alone with myself each evening, and I feel and see my body and what has been done to it, I have to live with that mental/emotional weight and literal physical pain and discomfort.Ā I feel like a fool for having gone into debt to payĀ someone moneyĀ to do this to me.
In the end, Iām alive, whatās done is done for better or worse. But it was a painful and costly path to take, and I feel grief at the idea that someone else might go through the same thing.