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Top Surgery still deemed a life-saving procedure for most trans men

By: Ryan Cassata*/Trans Headlines

My top surgery was 8 years ago. I still remember the day as if it were yesterday. It was one of the most important days in my life—a true turning point for me towards self-acceptance, mental and physical comfort. 

I went into the surgical center with my physically uncomfortable Underworks chest binder, feeling 100% ready for whatever last pain and discomfort would come post-surgery as I healed into my authentic self. The level of pain from the incisions was not on my radar at all. I was unafraid and 100% ready for any amount of pain because I knew that the surgery would positively impact my life. Any amount of pain was worth it to me.  

To make a long story short, top surgery eased my gender dysphoria remarkably. I went from feeling suicidal to feeling happy and confident. Post-surgery I learned that I could give someone a tight hug without feeling dysphoric. I could take my shirt off at the beach or even around the house to feel some gender euphoria. The image of myself in the mirror was finally validating in a way that it had never been before. My flat chest made sense to my brain and because of that, my dysphoria eased significantly. 

I was 18 when I got top surgery and now I am 26. By now, I have long settled into my chest. It honestly feels like this is the way that my body has always been. I believe it is because this is how I was truly supposed to be. My body has changed a little bit as I got older, as most people do; it undoubtedly feels more like home now. 

The most common question that I’ve gotten over the past 8 years is how has not taken hormones affected my chest? Not being on testosterone has not affected my chest at all. I have not had any chest regrowth. That was a concern for me before I got top surgery and because of the procedure that I got and having one of the best surgeons [Dr. Brownstein] in the country (in my opinion), I’ve been very fortunate to have had incredible results and have never needed a revision. 

Below you’ll find a YouTube video from August of 2015 discussing some of my fears about top surgery without testosterone. 

It’s been 8 years now and I like to spend some time around my surgery date to reflect on how far I have come and how I feel in this present moment in my body. Does it feel more like home? Is it more comfortable for me now? Am I more able to express my gender freely? 

Eight years later, I am much less concerned about “passing.” I wear my hair long and, among my peers, I feel seen as my true self. It’s not about male or female anymore but about “do my friends see me for me?” As Ryan? And, they do.

I am also now much less concerned about how the outside world perceives my identity and care way less about the judgments of others. I have learned that feeling valid as a trans person, and as a man, comes from within, not from the outside. 

I don’t think about having a flat chest much anymore. I remember after surgery I would put my hand on my chest a lot to feel the flatness, a quick source of euphoria at the time. Now it just is, and it feels like it always was. Somehow, having a flat chest has made me much more comfortable with my lower half and has eased bottom dysphoria a ton, which has been significant in my journey to loving myself. 

I spend a lot less time trying to fit into what a trans man should look like, according to society. If I want to wear a hat, I do. If I don’t want to wear a hat, I don’t. If I want long hair, I grow it. If I want it short, I cut it. I am able to wear the things that I want to wear without worrying as much about the gender labels on the clothing. It doesn’t matter if it was meant for girls or boys. It matters if it feels right for me personally. Everything is gendered in our society, but for what? It’s just someone’s judgment and perception. I realized I don’t need to follow someone else’s judgments of what gender is. 

I think less in terms of gender and more in terms of self-love. Does this serve me or not? If it’s harming me or holding me back from growing, the idea needs to be thrown away. I’ve spent a lot of time throwing away old ideas in the past 8 years. Letting go of my perceptions and judgments about what a man is and what a man is not has led me to a freedom that I never thought I would experience. It’s also allowed me to be a better trans activist and a better ally to those who don’t fit in the binary. 

Eight years later, I still do experience gender dysphoria from time to time but it consumes way less of my energy. It causes way less discomfort and way less shame. It passes quickly and it’s no longer debilitating.

Eight years after top surgery, I don’t worry much about gender anymore, I mostly just worry about my safety as an openly trans and androgynous-looking person in this world.  

I’ve enjoyed the ride so far. I have no regrets about my top surgery or my transition. I feel more at home than I’ve ever felt in this body. I am still extremely grateful for getting my top surgery. It’s a privilege and it’s allowed me room to focus on many other beautiful aspects of my life aside from my trans experience. 

*Contact Ryan’s Management with questions at mgmt@ryancassata.com