Top surgery (English)

Less is More

One of my earliest memories of getting breasts is the feeling that a choice was being made for me at that moment. From now on I’m a woman, I’m trying to be a woman — whatever that may mean. Every time I tried out a more feminine side of myself, in clothing or behavior, it felt strange. I quickly went back to the aesthetics where I felt comfortable.

But those breasts were there. It felt like they were in a continuous state of betrayal, showing everyone what I was, but couldn’t or didn’t want to be: a woman. They constantly gave me the feeling that I had to do things to go along with what they told me about me. It felt like they weren’t part of my own body; the boundary of my body ended somewhere before my breasts began. Yet I was reminded daily that they were there. In the mirror, or when I walked past something and they bumped against it, or when I “had to” run. In all those moments I kept thinking: You’ll be gone someday. Without thinking much deeper about it.

This thought gave me peace. It made it possible for me to hold out for a long time before I took this step. Looking back, I think that until that moment I was never stable enough, nor clear enough, to make that decision. There are many factors involved anyway. You continuously hear around you how people are dissatisfied with their appearance, specifically their breasts. How I felt was maybe a bit worse, but apparently it was a fairly normal thought to be dissatisfied. Why would you undergo so much pain and effort if you’re otherwise reasonably happy?

Because I had been so aware my whole life that I didn’t want breasts, the moment of decision went quickly. It came down to me talking with a friend again about my wish and she said: “Why don’t you just do it?” Yes, why didn’t I actually just do it? I had never researched what the possibilities were or what steps I needed to take for a top surgery (breast removal operation).

This led to several months of research on official sites, but social media algorithms also quickly got my interest. More and more transmasc content came by, which showed me what the possibilities were and made me think about what it would mean for my identity after top surgery. I quickly discovered that the idea of being a woman without breasts scared me even more than being a woman with breasts. Those breasts had always betrayed me, but if they weren’t there, there would emotionally be even more emphasis on the fact that ‘being a woman, without breasts’. I felt from everything that that wasn’t who I could be. Starting to think about what the hate for my breasts meant and where it came from led to the realization that I’m trans.

Practical Preliminary Research

Now such a decision has been made, where do you start? Fortunately, there’s a lot of information online nowadays. It quickly became clear to me that there are various places where you can sign up for a waiting list, and that those waiting times are often long. Also, it’s mandatory to get a diagnosis first before further steps can be taken. For my GP this was all new, but fortunately she was helpful and thoughtful. She got me on the waiting list at the right places via a referral.

These are the waiting lists of several larger hospitals that offer all aspects of transgender care (guidance, diagnostics, hormones and operations; you can of course choose where you need what). Besides these hospital departments, there are also collaborations between organizations. So there are various GGZ organizations where you can go for a diagnosis and guidance, which work together with organizations that do hormone treatment or operations. I decided to sign up everywhere to then see where I could get in first. Through connections I ended up at Transgenderzorg Utrecht, from where I got a referral to Gender Clinics for the top surgery. The time from first conversation to operation turned out to be slightly less than a year, which is fast for trans care.

Still, time seems long when you have to wait. During this period I was able to flip the switch and figured that I could at least take the time to go into the operation as healthy as possible. Quitting smoking, exercising and eating healthily were the things I could hold onto. They gave me the feeling that I was making progress, while time seemed to stand still. Every day I was busy with the moment that would come: top surgery. Not once did I feel doubts or fear that I wouldn’t be happy with the result. Of course you’re aware that things can go wrong and you don’t have everything under control yourself. Still, for me every outcome would mean that my feelings and my body could finally be one. This decision I had made long ago; now only the moment had arrived to actually act on it.

The Day of the Operation

Finally it was time. The day of the operation broke. I found it nerve-wracking, naturally, because you don’t know exactly what awaits you and hope everything goes well. But mostly I was enthusiastic. I had waited and thought about this for all that time. Now the moment had arrived that had played out in my head many times already.

When I arrived at the location I could actually go straight through. With the words ‘they’re already waiting for you’ I was led into a room. Clothes off, paper gown and ‘hospital socks’ on, and lie down on a bed. All preparations were made and I was wheeled into the operating room. Now that I think about it, about a year later, I’m not actually sure anymore. Maybe I did walk and lay down on the operating table myself. That, that fuzziness will probably be from the anesthesia. I was out and then awake again; in total it lasted slightly less than an hour and a half. I know I woke up with the feeling that I was cold, noticed that I wasn’t wearing my socks anymore. When I asked the nurse if she’d put them on for me, she answered something that made me suspect I had already asked her to take them off before. I couldn’t remember that myself; for my feeling I had just woken up.

Shortly after I came to lie on the wardroom from the recovery room, the surgeon came to check. The compression binder that was over my chest could be opened briefly. I remember I could only think: Quick look! Beforehand I had talked about how it would be to see your chest without breasts for the first time. I wondered if it would feel weird or strange, or if my brain might miss them. The only thing I felt at the moment I saw it was: Hey, I look like I already felt. I felt good, fuzzy but good. I was also well cared for; within a few hours I had already had three cups of coffee and suddenly it was time to sleep. I don’t want to say it was from the coffee, but sleeping wasn’t going to happen for me that night. Fortunately I could be picked up the next morning to go home. To sleep comfortably in my own environment.

One of the most important rules is that you’re not allowed to lift your arms, but when my mother came running up, I was waving wildly. That was getting used to for a moment, but I was cheerful and felt wonderful.

Still Need to Recover

I’m someone who doesn’t get bored easily. So even if I have to stay in bed for a few weeks, I still entertain myself. Otherwise I felt very good, I only took painkillers for two days. For the first four weeks I had to wear the compression binder. That was nerve-wracking in the beginning to take off, when I wanted to show someone what the result looked like, but I also did that gladly. I felt proud of my new chest right away. In the beginning I needed quite a bit of help, because you’re not allowed to lift your arms and also not lift more than one kilo. Fortunately I have enough people around me who wanted to make time to take care of me and help me with everything I needed. It was a nice feeling to notice that everyone was so involved and could empathize with me.

From the first day I already made small walks. Because of this I really felt that I still had a lot to recover. The first few days I didn’t get further than a few hundred meters and then I had to turn back already. That got better very quickly, but it really took a while before I could walk without thinking about turning back in time. My head was still fuzzy (from the anesthesia) and I also slept a few hours every day during the day. Once a day the compression binder could come off and then I could enjoy that moment in my bare chest. It felt liberating every time.

The Small, Big Happiness

The bras could go, that went with a big laugh and little effort. It does still happen occasionally that I think in a flash in the morning that I forgot to do something when I put on my shirt. That’s the years-long habit that doesn’t disappear in one go (not like the 1.2 kilos that I was lighter immediately after the operation). And then the realization: I never have to buy bras again. These may seem like small things, but these are the differences between discomfort and feeling comfortable in daily life.

After the recovery period (first four weeks with compression binder) I enjoyed walking around without a shirt at home right away. The first year you’re not supposed to be in the sun yet, to make sure the scars heal properly, but I remember well the first time I went walking in the woods without a shirt. Sheltered under the trees, just to feel how it was. It did feel a bit naked to be honest, but also free and happy. The wind along my chest was a pleasant feeling and that definitely tasted like more for the coming summer.

I love running my hand over my chest now and I do that often too. It’s like I’m catching up on all the time I avoided touching myself there. Not necessarily only in intimate moments, but also in simple moments where you say something about yourself and place your hand on your chest as non-verbal communication. Recently I caught myself stroking my chest while standing talking with a colleague. I had to laugh and wondered if that was normal.

Where I used to feel a small disappointment shoot through me every day when I was reminded of the fact that I had breasts, I now literally feel a stream of happiness every day at the moments when I realize that I now only have a chest. When I see my reflection I look for a moment and say to myself Thanks Rems. Thank you for allowing yourself to take this step. Best choice ever.