Friend wants top surgery

@Jigglypufff I can't see that your friend has asked for your opinion. So why give it?

Of course an adult is going to make the decision for themselves.

However, some people MAY listen to a friend who raises issues that they have not considered. OP’s friend may consider it. Of course, they may not either.

Sadly, with the lack of honest and long term discussion in the past about the impacts of mastectomies (and I understand why cancer patients have not discussed this by the way ) and the glamorisation of these surgeries in the way young people are showing off their scars as models etc, it is hard to break through the anticipated euphoria this surgery will bring.

Whilst I loathe the idea of unnecessary surgery and would fear the potential outcomes, I now have to agree with those who say "let them".
My caveat is that this surgery is paid for privately by the individual, and not at the expense of those whose very lives are at risk from cancer (ie waiting lists).

Let them buy the surgery.
Let them have the full experience, whatever that is for them.
Let them handle whatever consequences arise, positive or negative.
Let them.
As long as they're adults and self funding.

I don't see any way of changing someone's mind if they're determined.

"Why didn't an adult say I was doing something stupid?" usually means the professionals who immediately affirm rather than exploring. Not other friends.

And there are plenty of detransitioners who say "nothing my family or friends said could have changed my mind, I wouldn't have listened, I had to work it out myself".

Often people find a bubble, online or in real-life "support" groups, all telling each other that the only reason other people question their decisions is because they don't get it and because they are transphobic. Even saying that a detransitioner who talked about his regrets and the negative consequences to his own body "was paid to say it" (yes, I've been told that)

As a friend you may have to accept that she is pulling away from you to a place where you can't honestly go with her. Maybe you really can't stay that close any more. And grieve that too.

'a reputable professional' - there lies the rub.

WPATH recommend men and boys who wish to be 'eunuch gender ' are supported in accessing castration.

This is the 'reputable' organisation behind a lot of the pushing for 'gender affirming' surgery.

(Of course, surgeons who are happy to profit from people with body dysmorphia may not subscribe to WPATH, but seem happy to reap the financial rewards of the ideology, regardless.)

A bilateral mastectomy is harm. Actual physical harm which cannot be undone and which has permanent harmful effects. So even one woman regretting an unnecessary surgery is one too many.

In normal circumstances, this major surgery is only carried out to save a person's life. That's not the reason for it in this case.

The point about bodily autonomy is a straw man, as is the claim of infantilising the friend.

I don't argue that this particular woman is not able or competent to make the decision, it's the wisdom of the decision which is being questioned. She may be under the influence of an ideology or receiving biased advice. Given what we know about the results and potential complications of the surgery, the rates of regret and the incontrovertible fact that a bilateral mastectomy is not clinically indicated but rather is being offered/sought for ideological reasons, a friend would beg her to think again, or wait, or get advice from non-ideological sources, sources which do not minimise the seriousness of the surgery or gloss over the consequences of taking this step.

The friend wants a bilateral mastectomy. She doesn't need one. Whatever medical advice she is getting, it's not that she needs one to save her life, because that is not true.

I think it's ultimately their decision to make as an adult - to me this is a medical decision. I have zero medical training so I'm not going to position myself to tell my friend that I know better than the actual medical professional they've consulted with. I fully understand the concerns around detransition and regret etc but ultimately I respect their right to bodily autonomy so as long as they have thought it through and are going to a reputable professional for medical guidance then I'd respect their wishes.

I also know people who genuinely seem to be happier and more content post surgery though- I think all you can ever do for any adult is make sure they feel informed and are making what they believe is the best choice for them. Not everyone who has top surgery is miserable and regrets it.

"But then at the same time you hear every detransitioner say "why didn't an adult say I was doing something stupid?"."

Because the ops friend is an adult themselves. I don't think we need to infantalise people who think differently to us. It's one thing for me to challenge if a friend was seriously misusing alcohol or drugs to harm themselves, its quite another for me to challenge them because they have sought medical advice from a medical professional just because I don't agree with the mindset behind it. So no I would not be inserting myself and my opinions in this any more than I would if a friend told me they'd decided to get a boob job or a nose job.

I can't find it for the moment, but Helen Joyce linked a blog (from a detransitioner) on her Twitter which compared this to an addiction.

I'm just going to comment that when women want to state their feelings and their inner 'identity' about an experience which is solely female and rooted in the facts of female biology and where inability to breastfeed is usually because of a lack of external support we're told our feelings aren't valid.

But when females claim their inner feelings tell them they're not really female because of a male driven ideology with no basis in reality or fact, they're cheered on.

Why could there be such a madly illogical dichotomy? (I know why)

Oh MissScarlet I'm so sorry that you had such a difficult birth experience and the medical professionals tried to force you to do something you didn't want to rather than, you know, just support you to breastfeed successfully and I'm so cheered by the fact it worked out in the end for you and you have two lovely DC.

Heaven forbid that women might actually know something about their own bodies and minds that doctors (traditionally male, and still steeped in patriarchal attitudes even if female) do not. And doctors are bloody clueless about breastfeeding. They tried to get me to stop when taking an antibiotic they actually give to premature babies. I can't think of any reason other than wanting to punish a woman just for the sake of it. Fortunately the wonderful Dr Hale's Medications and Mother's milk put them straight (why on earth GPs just don't have copies of this, I'll never understand - probably my previous point).

The studies up to about two years ago showed that the average time for detransition or deep regret but where a person doesn’t feel they can detransition is 7 years after treatment started. And too often it was after all the options had been explored- because there is a ‘chasing euphoria’ aspect. When someone realised that the treatment they just had didn’t make the difference that they expected, they look for the next stage. When they had gone as far as they could, the realisation sinks in that nothing will work for them.

I suspect that since those studies which were focused on pre - 2017 transitions, with the exponential increase since 2017, the affirming only treatment implementation etc, the cycle might now be shorter.

Remember, there is also going to potentially be a period of euphoria leading up to and after the surgery
I thought about this when a pp talked about their feelings one year post-op.

There is also the question of whether the NHS should perform elective surgery for a non-medical condition on a healthy body with no deformity, illness or medical reason to remove the perfectly healthy, normally conformed and functioning body part.

Having said that, there are some cosmetic surgeries that IMO shouldn't occur in private practice either (eg. brazillian butt lift which regularly has horrific complications).

But if it impacts a friend's life negatively and you then provide emotional support or physical support for that friend, can you (general you) then say that 'it doesn't actually affect you'?

I must admit that I would be laying out everything that I know about gender identity and double mastectomies to my friend.

In saying that, I also know that some people will simply do what they want to anyway.

Remember, there is also going to potentially be a period of euphoria leading up to and after the surgery. Although, we have heard from some people that that euphoria doesn't last long when they first look at their lack of breasts and realise that that made no difference at all in how they feel. Or, that euphoria can last for a few years until the realisation that it was all done for a belief and that the negatives now outweigh the positives.

I would think that it is very hard to listen to reason when that euphoria has set in.

Cross posted, TheCatsTongue

Do you not care what happens to your friends as long as it doesn't affect you?

Have you read any of the posts from women who have had mastectomies on this thread?
This is not just like her friend becoming a Christian, or a Buddhist and the OP feeling uncomfortable with that. The friend is set on a course of action with real harmful consequences for her body and mental health and additional harms which will manifest in the future. All for the sake of a philosophical belief which the friend could hold without having major surgery.

It's the friend's decision, ultimately, but whatever the issue, if a dear friend was, in your view, going to physically hurt herself unnecessarily, then as a friend it is entirely right and appropriate to voice concerns and try and turn her away from danger if possible. I personally know of a detransitioner, now in psychiatric care, who is very bitter than nobody even tried to stop her from having surgery.

But then at the same time you hear every detransitioner say "why didn't an adult say I was doing something stupid?".

People's silence and reluctance to disapprove is seen as tactic support.

The OP should be aware what will come down the line, but I think only want to hear positive affirmative stuff about their friend.

^ this. If they're an adult it doesn't actually affect you. It's their decision to make. Your approval or lack thereof is neither here nor there. So I'd let them make their decisions and I wouldn't be inserting myself.

Adding that I hear this quite often from women - breastfeeding difficulties are not in isolation, they are often coming after/during difficult birth, postnatal issues.

Women often feel breastfeeding is a very important part of bonding with their infant and a way to heal from other birth related trauma. And indeed evidence shows that parts of the breastfeeding process do have long lasting effects on the baby as well as benefits for the mother.

Anyway, I don't want to derail.

Thank you. He's now a very happy and healthy almost four year old who eats like a horse and stays whippet thin by constantly racing around on his bike.

He self weaned from breastfeeding at 15 months old when I was pregnant with his little sister (who is still very much into breastfeeding at 2 years old and I have no idea how I'm going to wean her).

I'm so sorry, MissScarlett. But an enormous well done for succeeding. It's unfortunately quite a common story, despite all the evidence of the benefits of breastfeeding. And there is a huge lack of support and help for new mothers, as noted above. That's got worse across the board in recent years.

Aww MissScarlett, im really sad to read what you and baby went through. I'm truly hoping he is now a healthy bairn. That must have been so terrifying xx

Oh yes. I had recurrent miscarriages trying to have my first child, had to have significant help to stay pregnant, then I think my placenta failed in late pregnancy, I presented at the hospital with concerns about reduced movements and was rushed into immediate induction which ultimately failed and resulted in an emergency C-section. My baby was unexpectedly born on the 3rd percentile for weight (after measuring normally at all scans) and lost almost 10% of his body weight in the first 48 hours before my milk came in.

I was so desperate for my body to just do one thing as nature intended, i.e. breastfeed, and yet I was faced with all these medical professionals telling me I was risking my baby's health by not giving him formula and that my desire to breastfeed was more ego driven than anything else.

I held out and ultimately had a long and successful breastfeeding journey, but the idea that I might not be able to was so upsetting and contributed significantly to my birth trauma.