'My scars aren't a finish line': three trans and non-binary people on how top surgery changed their lives

For many trans and non-binary people, top surgery – the process of removing breast tissue to get a flatter or masculinized chest – is not an elective procedure. It’s essential to them feeling at home in their bodies. Top surgery is a form of gender-affirming healthcare that can be used to treat dysphoria, the sense of deep unease one feels when their identity or appearance doesn’t match up with the gender they were assigned at birth. It’s also a complicated, intense and invasive process that requires navigating a maze of insurance paperwork, and from which it can take years to heal. This means that the road to achieving one’s “dream” chest can be a long, complex and fluid journey.

The number of gender-affirming surgeries rose steeply in the US between 2016 and 2019. Since then, more trans and non-binary people have publicly documented how their bodies – and their relationships to their bodies – have changed, even as anti-trans legislation has ramped up across the country. “Everybody’s skin is different, and healing can look so different,” says Dulcinea Pitagora, a psychotherapist and founder of the LGBTQ+-affirmative practice Manhattan Alternative.

Pitagora has worked with some clients who are anxious about their scars showing because they are “worried about being outed, or someone hurting them for being trans”. That fear is exacerbated by the fact that Donald Trump, who has threatened to roll back LGBTQ+ rights, has won a second term. “We see increases in mental health symptoms caused by even hearing about [anti-trans] legislation in other states,” Pitagora says. “It creates more risk for clients, and it could affect whether a provider is willing to give gender-affirming care.”

Despite the baggage that can come with one’s scars, they can also become symbols of pride and resilience. The Guardian spoke with three trans and non-binary people across the US about their top surgeries.

https://www.theguardian.com/wellness/2024/nov/19/trans-nonbinary-top-surgery-scars