Transgender Teen Survival Guide

Asked by Anonymous

Lee says:

The difference: If you get top surgery, you can go shirtless because you have a flat chest. If you get a reduction, you have a smaller chest but may not be able to go shirtless.

Top surgery usually is a double incision/bilateral mastectomy or a keyhole/peri-areolar incision and the goal is to have a flatter chest like how many cis males do. A breast reduction is making your chest smaller, but not really flat. So with top surgery you’d go from a D cup bra (for example) to not needing a bra, and with a reduction you’d go from a D to a B.

If you got a reduction, you could still bind if you wanted a flatter chest. Choosing one is based on what you want to achieve with the surgery. If you want a reduction, you might want to start with talking to your parents and doctor. 

If you have a larger chest, often insurance will cover a lot of the cost because having a larger chest can cause back pains and be a general pain. If you want top surgery, often insurance will cover it if you get a letter from the therapist and are diagnosed with gender dysphoria.

Some people who are genderfluid may want to have a reduction instead of top surgery for their “girl” days, for example. I also know some non-binary people who want to have boobs, just smaller ones so they’re easier to bind. Some trans guys may also want a reduction since they’re okay with their boobs but want them to be more discreet. 

Some non-binary people want a flat chest and get top surgery, and some trans guys want a small chest and get a reduction. Anyone of any gender could get either one.

If you’re okay with having boobs but you want them smaller so they’re easier to bind, then go for the reduction.

If you want to have a flat chest, don’t settle for a reduction because it’ll probably cost the same, it’s the same amount of recovery time, and if you later deicide to get a top surgery you’ll have to do the whole thing twice and may have less sensation. Getting top surgery can get you a flat chest no matter how big your chest is to start with, so you never need a breast reduction to prepare you for top surgery. So get the surgery that you actually want the first time.