If I ever get top surgery I fully intend to get barbed wire tattooed over the scars as a Wise Blood reference. I refrained from giving him scars, though, because transition is an acceptance of grace, it’s transformation, and it’s a step towards life. Hazel Motes isn't doing any of that. His binding with barbed wire is more analogous to self-harm (I mean, it literally is), than top surgery. He's a cautionary tale, and when I'm at my most self-loathing/self-destructive/perfectionist/morally obsessive/compulsively avoidant his character feels like a mirror I'm looking into. If we're really looking for a trans metaphor, it's Enoch, but the book told me not to worry about that so I'm not going to (for now, at least).