Radical Reduction Top Surgery Helped Me Define My Body On My Own Terms — & You Probably Haven’t Even Heard Of It

The picture I took the day of my top surgery consultation was a live photo. When I play it back, it's clear how much my hands were shaking. Making it to that waiting room, as it is for all trans and gender-diverse people who seek medical gender affirmation, was a triumph in itself. I was still terrified. I wanted this consultation to go well. I needed it to go well.

My surgeon called me into her consultation room, and I explained my experience clumsily while she listened. Looking around the room, I eyed the little pride flags, remembered her testimonials, and decided to share my experience candidly with her. I explained that I had compressed my chest for many years, how it had impacted me, and how the size of my chest made the androgyny I desired as a non-binary person near impossible. I spoke to her about how the movement and heaviness of my breasts were as much of a weight mentally as they were physically. Cautiously, I showed her the only photo I could find that I had someone that looked the way I wanted to. They’d posted their results on a forum I’d scoured for years. A palm-sized amount of tissue remains on the person’s chest, not the flatness typically associated with top surgery.

“Yes, we can do that,” she said. “We would call it a radical reduction, but it doesn’t matter what it’s called as long as it does what you want it to do.”

She said yes. I was going to get top surgery. More importantly, I was going to get it how I wanted it, I didn’t have to compromise on my desired result for my body. I was struck by my surgeon, and how she followed my lead, and I expressed that to her. She shrugged and told me that it was my body and my life in that body that she cared about. That exchange told me she was the surgeon I needed to take this step with, and that I could trust her on the operating table. She took my measurements, explained very carefully how the procedure would work, and we pencilled in a new date on the calendar; August 16. Top surgery day.

Sometimes I wondered whether what I was pursuing deserved the title of top surgery, questioning whether I was “trans enough” to consider this procedure gender-affirming care. Gender affirmation is about feeling an incongruence between your body’s gender perception and your perception of yourself.

The way I had interacted with my chest since it had undergone puberty was one of pain, shame, and suppression. I had been binding my chest to reduce not only my chest size but also the hypersexuality and feminine ideals that get projected onto a large chest. I needed that weight off my chest (I made this joke daily while waiting for my surgery date). My friends who supported me during this time reminded me that transness is not a comparative exercise, it is an experience that is yours and yours alone. While we find community with other trans people and find comfort in shared experiences, we are not in competition with one another.

In the lead-up, I made a conscious choice that I would tell people I was getting top surgery. I corrected others when they called it a breast reduction. It was important to me that the people around me knew that this procedure was to help affirm my identity and my experience as a non-binary person. Not having to align myself with the binary, and being supported in that, mattered to me.

Together, we took my chest from roughly a G-cup to an A. As soon as I could, with my surgeon’s permission, I got up to look in the mirror. I looked like myself, I had a small chest with soft curves, and stretched skin cut away. I was still swollen and bruised but that hardly mattered. I was completely aligned with what I had hoped for going into the surgical room. Pain, in my back and brain alike, melted away.

As I healed, I got to know my new body better. My body will not completely settle until about six months post-op, but I am fully mobile again, able to run and climb and live how I want to. My scars have a long way to go before they fully heal but I wear them like a medal. I have about a palm-size worth of tissue, like I asked for, and I haven’t worn a bra since having the surgery. I would align the size of my chest closer to pecs than breasts, purposefully existing outside of the binary.

Shannon May Powell writes for Archer that gender non-confirmity is “always transitory, transforming, trans in its essence. Something that represents possibility and infinitude.” Top surgery allowed me an androgyny and ability to explore my masculinity that I had been seeking for a long time but also had the unintended effect of returning to expressing femininity through a new lens. The chest I had resented for its hypersexuality no longer existed, allowing for an extension of possibility. I wore ribbons, swimsuits, and shoes with a heel without the worry I was misrepresenting myself, letting my gender expression expand infinitely outward. My top surgery was very accurately described; a radical reduction.

Top surgery, as my surgeon told me before I went under, “is life-saving”. I understand what she means now. I have lived my life more authentically in the months following my surgery in August than ever before. If you want to see the results of my surgery, you could look at my chest, but you will see more results the curve of my smile and in my shoulders, pulled back, allowing me to stand proud.