So, let’s talk about surgery. I had known for many years – decades actually – that I wanted to have top surgery. I had no clue that was what it was called, though, due to my lack of knowledge around transitioning. I did know the definition of mastectomy and knew that having one would be key to me feeling more “male.” Despite knowing this, I spent many years not even knowing that I could have a surgery for this reason. I’d only heard about women having mastectomies for cancer or whatever medical reason made it necessary. As much as I wanted to have surgery, I didn’t know you could just do it because you wanted to do it. I’d never heard of top surgery or gender affirmation surgery or even the word transgender.
Boy did my world change when I found out that you could, in fact, have surgeries to make your physical body match what you were feeling inside! I hadn’t the slightest clue how to make something like that happen, but I kept telling myself that someday I would figure it out. The best I could do until then was to do everything I could to feel more like a boy. As soon as I was making my own money I started buying and wearing sports bras. They weren’t a perfect solution, but they made things much easier – no more hooks and straps falling down. I had never heard of a binder, so this was my best option. With a sports bra and baggy shirts I hid my chest as best as I could.
I was fortunate to find a plastic surgeon with a strong focus on female to male top surgery. I made the 3 ½ hours drive for my scheduled initial consult with my letter from my therapist in hand. I spent only a few minutes in the waiting room before the nurse called my name. I was escorted to an exam room, with a quick step up onto the scale conveniently placed in the hallway where one would be hard-pressed not to see it. The nurse handed me the standard blue cotton split open tie it in the back gown and I was instructed to remove everything from the waist up. She said she’d give me a few minutes and would be back to take my vitals.
Then it was time to meet the doctor. The nurse had barely left the room and in walked the white coat. Each person on this staff worked more expeditiously than the last and for a second I worried that this might be one of those doctors where they rush you in and out. But, I was wrong. After a friendly greeting, an introduction, and confirmation of my preferred pronouns – which she wrote in my file, the doctor reviewed the notes from the nurse, glanced over the letter I’d brought at their request, and settled in on the silver spinning rolling stool to talk. She started by asking why I wanted top surgery. She asked me to stand in front of a black background while she took photos for my file. These would be the photos she’d use to plan the procedure in detail as we neared my future surgery date. While she positioned me for shot after shot she began to explain how she anticipated the surgery would go and how she refused to provide anything but the choicest care and attention to detail. She wanted me to be entirely happy with the outcome. She talked of the different components of top surgery – bi-lateral mastectomy, nipple grafts, and liposuction. I had researched top surgery procedures online and learned a little about what I could expect, and hearing the surgeon’s detailed description told me that I’d only scratched the surface when it came to knowing what lay ahead. She was so thorough as she hit every bullet point on the checklist in her head, that she left little to question.
The next step was for me to get a mammogram while they started the process of obtaining insurance approval. Every insurance company and every insurance policy is different so there was no way to know how much – if any – of the surgery my insurance would cover. It was time to wait and wait some more. I called my general practitioner and got a referral for the mammogram for the next week and had the results sent to the surgeon in Kansas City. Done. More waiting.