Friend wants top surgery

[Jigglypufff]

One of my closest friends is saying they are non binary and has changed their name. I have gone along the route of not making it a big deal, like "ah that's nice pal, which film shall we go to see this weekend."
I don't know if this is the right tactic. I have been vocal about the fact that I don't understand why we would be boxing gender into stereo types- ie. Makeup and high heels does not a woman make. You can wear masculine looking clothes and still be a woman. Etc.

They now are saving for top surgery. Should I just keep with my current tactic? Im worried about side effects? They aren't on any hormones.

I just feel a bit like it's getting away from them, the name change etc has been very quick after announcing they are non binary.

I'm also a bit sad if I have the right to feel that.

I wonder if the therapist is supportive of gender identity or more explorative? It was something that I had to carefully consider for my teen when seeking mental health support. And I assume that some adults are vulnerable as well and need more explorative rather than affirming.

Dead right. Like the thousands of lobotomies carried out in the mid 20th century, often on unruly young women. Brain surgery, originally intended to cure psychiatric disorders, being used to make the patient conform. Rosemary Kennedy, the US president’s sister, was the most famous victim.

So she is a lesbian.

This seems to be a very stereotypical pathway for lesbians now (sadly), first realisation of homosexuality, then identify as non-binary, then identify as trans and start cross-sex hormones etc, then regret.

As someone who has/had breast cancer and had to have a double mastectomy, I find the term 'top surgery' deeply offensive and an attempt to make something life-changing more anodyne and normal. But it is not. It's a major, and to a degree, radical lifestyle choice, one that cannot be reserved. I actually think it's an extreme form of body mutation and always a sign that other things are going on.

While I chose to have a double mastectomy, it really was not much of a choice. However, I did choose not to have a reconstruction, nor do I wear any falsies for a myriad of reasons including not being able to keep my nipples and the at the 'new' breasts would have no sensation. Truth be told, I find it rather liberating being flat-chested. To quote others, I am still supremely feminine without breasts. Indeed, breasts do not maketh a woman, but, if at any point in the future your friend wants children and wants to breast fed, they cannot.

A mastectomy is irreversible. It's also not just about not having breast, there will be zero sensitivity across the chest, breast bone, up to the clavicle and size of the rib cage. Is your friend busty? Is so, the scars will be large even if they surgeon is an artist at their craft. Does she want to keep her nipples? That's another complication that can cause issues and potential loss. There's so much that can go wrong that I know I wouldn't choose to do unless I had to. Does your friend note that the better surgeons are onco-plastic surgeon who only work with cancer patients? And, to be frank, and surgeon who is performing a surgery that is not needed on any medical grounds whatsoever is to my mind, not anyone I would want near me, let alone operating on me.

Your friend has choices. Pre-cancer, I rarely showed off my breasts or wore anything low-cut mostly because I was uncomfortable when I did. And even though I seemingly made a choice to have a double mastectomy and feel liberated, I miss my breasts. I think it's really important that your friend learns to love themselves and accepts the body they are in. Being non-binary is about not conforming to gender stereotypes, that's all. This does not mean surgically removing parts of one body.

Is your friend in counselling? If so, they need to explore why they feel the need to do something so extreme, because it is extreme. And chances are once they go through with the surgery, they will realise it doesn't make them happy, nor the person they seem to think they are.

Don't think it was, it was a story of a woman who fully detransitioned and came to regret the surgeries she had had. The story was told by a professional who had worked with a lot of detransitioners.

I'm also aware of a BBC3 documentary about two women who wanted both wanted to be listed as fathers on the birth certificate. Both no longer identify as trans, and BBC has never done a follow-up documentary.

PS. If your friend really must go through with this, for gods sake, make sure she looks at pictures of the surgeons work and talks to patients who have been through it. This is something my oncoplastic surgeon offered as a matter of fact, and as someone who has been through the process, I not only have pictures in their book but also talk to those considering mastectomy.

If the surgeon does not offer any of this, it would make me question their work and whether it is done to even a basic aesthetic standard.

But your friend is a woman and you don’t need to pander to her delusion on an anonymous forum.

It’s a double mastectomy, not the euphemism you’ve used here.

That is really sad to think that more than one female person has not understood.

Freddy was in a TV documentary - Seahorse.

It reminds me of the Swedish Fertility specialist who was raising the alarm that they had seen an influx of late 20 something / early 30 something female people seeking fertility assistance due to testosterone use. These patients had said they were unaware of the issues when they took testosterone.

A woman faces almost impossible obstacles if she wants tubal ligation under 30 “because you might change your mind.”

But a double mastectomy for cosmetic reasons is not just ok but “brave”?

I don’t mean any disrespect to @nbartist who has explained their reasons, but to willingly remove healthy parts of the body doesn’t sound like a positive outcome. It sounds like self harm.

I would rather the health care system helped people come to terms with who and what they are than perform serious surgery to make their actual self look more like a mental image.

It seems to me it’s the self image that needs adjusting, not the body, to be healthy.

I think every case should be considered on its own merit. In this case as your friend is not pushing for hormone replacement etc. I would look at it slightly differently. More akin to breast augmentation/reduction or other cosmetic surgeries which make them feel more comfortable. While not for me I wouldn’t judge someone for having breast augmentation etc if it brought them happiness but would still be concerned about the procedure and recovery etc.

doublec thanks for your thoughtful and informative post.

There really seems to be an element of denial about the brutality of these extreme body modifications. And all for what? Someone’s identity?

Remember that we have been now told that there is no medical condition aspect now to having a gender identity. This has been the testimony from academics who are transgender themselves.

That only leaves gender identities, all 130+ of them, as only having the philosophical belief aspect as the commonality bringing the concept together. And when you start to understand that this is all about philosophical belief and not addressing a medical condition, it starts to become relevant to understand what is happening and why.

Therefore these euphemistic terms used to minimise the reality of these medical procedures become very important.

It is emotional manipulation on a societal scale to use the following statement over one using accurate language: ‘I am non-binary and having gender affirming top surgery’.

Versus the accurate language of: ‘I have a philosophical belief that I am neither male nor female and have decided to have a double mastectomy as a body modification so my body fits my identity’.

The first tends to deter further questioning or thought. Whereas the second highlights the issues around these surgeries and treatments.

Particularly the question around supporting these body medications and even pronoun usage. Because what other philosophical belief do we support extreme body modification treatments for?

What other philosophical belief do we accept such significant changes to language for ? Language changes to the extend that laws and policies become rendered unclear. And where philosophical belief becomes prioritised ahead of sex based rights and provisions.

Whilst obviously it applies to the opposite sex, I think it's worth bearing in mind that WPATH, whose 'expert' Standards of Care many cite when discussing the rationale for 'gender affirming' surgery, also advocate for Eunuch to be a gender. This means that medically healthy men and boys who desire to be castrated are to be supported in pursuing that surgery.

The one I saw was fairly young - in the US, where it's possible.to get surgery earlier. She'd had a double mastectomy as a teenager, detransitioned in her early 20s and was asking how long it would take for her breasts to grow back now she was taking oestrogen. Clearly no informed consent for the original surgery.

And that seems to be a fairly common belief - because men taking oestrogen grow breasts, women who've had them removed can regrow them by doing the same. They can't.

At least one of the US gender butchers also says it's something young teenagers should be allowed to do without gatekeeping 'because it can always be reversed if they change their minds later'. It can't.

I was told I "must" support a trans relative. I said I couldnt support a child to put their hand in a fire, I can't support any deliberate self harm. It's not being a good friend to say nothing.

I'd have to say that top surgery is a way of making major surgery seem more acceptable. This is physically harmful and I wonder if there is another way of you feeling more comfortable with your body?

If they have had good counselling and they are determined on this you could support with transport, visiting, making meals - while still being clear that you think it's deliberate self-harm.

I remember reading that.

At least one of the US gender butchers also says it's something young teenagers should be allowed to do without gatekeeping 'because it can always be reversed if they change their minds later'. It can't.

In a culture where fake silicone boobs are so normal that women whose breasts are natural, and move naturally rather than as stiff bags of silicon, get derided as they "look weird", this view makes sense. It's fully "reversible" by having artificial silicone implants inserted. You have to remember that the purpose of breasts is for the gratification of men, then it makes sense because the artificial version is totally fine

It might be Prisha Mosley you're thinking off

My anecdata would concur with this - long term friend had & hated their large breasts and had been knocked back by GP on a reduction (to relieve back pain).

Friend had not long been out when they got in with queer crowd & within a few short years they’d out as trans/non-binary, had gender-affirming counselling and a double mastectomy.

Knowing that friend and how they experienced childhood and girlhood/womanhood I find it impossible to separate how their “trans identity” played out from their internalised misogyny and body dysmorphia.

I had a double mastectomy for cancer, and I couldn’t believe the number of meetings in which I had to defend my choice.

but we can do the work with a lot of minimally invasive entry points

but you cannot do that and not change the way you see yourself

but reconstructive surgery has become so well developed you’ll get amazing breasts!

When I asked whether the implants would be guaranteed for life, whether the minimally invasive surgery would lower as much as the double mastectomy my chances of getting cancer again, whether all the options proposed would definitely cause me fewer complications, the answer was mostly no and a few times we don’t know.
i had cancer and i had to justify for weeks wanting a double mastectomy.

then i read stuff like this. I despair. I would say let her do what she wants, we are all old enough to choose in life. Yet I think that one day they (all of them) will realise that the procedure did not make things easy in their bodies (forget about their minds), and that will be something else they need to live with.

Thé ‘therapy’ may explain quite a lot. Many ‘therapists’ seem to be gender advocates, and to thrive on medicalising confusion and distress.

It shows how poor the education system is (in Western culture).

All humans have breast tissue (2% of breast cancer cases are for males). The treatment for male breast cancer is also mastectomy.

The mastectomies that are had as part of non-binary/trans surgery actually mean that the individuals end up with less breast tissue than a male.

Hear hear.

Was relatively lucky inasmuch as I said on my day of diagnosis that I wanted the mastectomy and would not entertain any thoughts of reconstruction or even breast conserving surgery.) Was actually relieved when another focus of cancer was found along with two BCRA mutations as it was only then, they stopped calling me to double check my decision. Even then, and up until the day of surgery, I was told if at any point I wanted to change my mind and opt for reconstruction, I could do that.

It was only after surgery that my surgeon (a woman) disclosed that she would have made the same choice as me as it was the sanest thing to do given the complications that can arise from reconstruction, and my recurrence risk. (Sadly, a friend had every single complication post-oncoplastic reconstruction and that was under one of the very best surgeons in the country). She, my surgeon that is, also confided that many women are actively pushed into a reconstruction by their husbands and partners.

So many who opt for so-called top surgery have little understanding of what a huge surgery it is. I know that even though I read everything possible and talked to someone who had been through it, I still under-estimated the toll (and recovery) it would take. It's even more invasive and more of a risk than breast reduction surgery. If a mastectomy is done correctly, there is absolutely no chance of surgical reconstruction even with an implant or DIEP flap. The skin needs to be so tight that an expander can not be placed underneath.

it always astonishes me how reconstruction is the default and women are actively talked out of choosing to go flat, yet 'top surgery' is easy to get with seemingly little transparency about how invasive and risky it can, along with it not being reversible. Also, it's not quite as simple as once it's done it's done, there will always be scarring. There's always going to be a reminder of the surgery (and what was there before). Surely this would also cause someone who is dysmorphic/someone non-binary even more turmoil?

Am so fed up of women being reduced to their body parts and hair. Having lost both my breasts and at one point, all my hair, at no point did I feel this takes away from my femininity. Yet at every step of the way, my choices were questioned. (I did not wear a wig and rarely covered my big bald head). However, even without hair and breasts, people could absolutely sex me correctly. Being a woman is about so much more than breasts (and hair). It's coded into every single cell of ours, so is it a surprise we can tell just by someones stance, their gait, their mannerisms what their sex is.

I strongly suspect that should OP's friend go the surgical route, their feelings towards their body won't change. Worst case scenario is they trigger more even unhappiness.

Edited to wish @Persimmons123 well for your recovery and future 💕

I'm stunned to hear those stories, Persimmons and doublec. It's galling that anyone would have to fight to make an informed decision based on a sensible risk assessment, rather than one based on what is assumed that women would want and rate as priority.

Depressingly, it seems to reflect an underlying assumption that women's bodies are most importantly embodiments of desirability through the male gaze.

It is dehumanising.

I would ask her whether this means that women who wear AA cup aren't women? Or men with moobs aren't men?