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Monday, March 13, 2017

Why I Threw Away My Binder And Am Not Having Top Surgery

When people ask me why I went off hormones, I have my nice long list of reasons, and since one of those reasons is that my beard and deep voice aren't going away it's usually easy to get people to understand why I don't feel I need to be on hormones for life (the acceptance of menstruation is harder to get people to understand, but it's also not something people see).

Something a lot trickier to understand is how I went from trying desperately to raise funds for chest reconstruction, binding every day, and generally speaking wanting top surgery to not only not wanting to have my chest altered, but giving up binding.  The reality is that gender dysphoria (the discomfort a transgender person has with zir physical appearance) is always not as straightforward as "I want all my parts to be man parts" (or woman parts, or something else).  A lot of it has to do with how other people react to those parts.

And mind you, I am an anomaly here.  Most trans men want top surgery and likely will continue to want it even if they are read as men without it, have very supportive partners, etc.  But for some of us, the discomfort we feel actually has nothing to do with the literal configuration of our bodies, it has to do with whether or not other people value us and accept us as the gender we say we are.

In my own case, I hit the jackpot when it comes to losing my chest dysphoria after a few years on hormones.  I have a very supportive, trans-friendly partner.  My body shape makes it very easy to hide my breasts under clothes, and even without a shirt on people don't necessarily read them as women's breasts.  My facial hair and voice tends to rewrite people's perceptions about the rest of me.  So having breasts just isn't that big of a deal, at least for now.  There is a chance, of course, that this will change in the future--especially if I lose weight and my chest stops looking proportional to the rest of my body--but for now I've tabled any plans to modify it.

In addition, I stopped binding.  In fact, I stopped binding long before I decided to table surgery, which is probably a big part of it.  I have a history of asthma and rapid weight changes, making binding very painful and hazardous to my health, and that's in addition to the usual problems of itchiness, gross smells, and expense.  One day I looked at my binder before going to work and made the snap decision to not wear it that day and see how it went.  It went fine, so I tried it again.  And again.  It's been about a year now... I changed what size shirt I wear and avoid certain patterns, but my ribs have never felt better... and I was fine.

Not only did I find I was fine, I found that sometimes I even like them.  On a bad day I'm ambivalent, on a good day I value the extra skin sensation, the opportunity for increased bondage situations, the convenient shelf for  our tiny household dog to lay on.  Sometimes, when I'm feeling particularly femme, they work well in that aesthetic.  So generally speaking, my breasts are fine.

Unfortunately, there's more to the story than just being "fine."  Yes, I'm fine, but some of my reasons for this are not fucking fine.  Please be aware that the rest of this page contains descriptions of surgery results as well as dermatillomania, a self-harm disorder.

I'm fine with my chest, or I would have sought out surgery no matter what, but I needed to get something else off my chest (see what I did there).  I probably wouldn't have thought about tabling the whole top surgery idea were it not for the fact that surgery results scare the shit out of me.

And I'm not just talking about botched surgeries.  I've seen a lot of terrible top surgeries out there (today there's a GoFundMe floating around asking for funds to fix one that is downright disgusting [click this link at your own risk, it's very graphic, and while we're at it if you know this guy please encourage him to seek out a lawsuit because Jesus fucking Christ]).

I also am protective of my nipples.  I see a lot of surgeries that have really wonky nipples that are either in the wrong place, sized differently, or scarred up.  It's so common for trans men to wind up with missing or mutilated nipples that there's now a guy selling replacement nipples on the internet.  And you know... nipples aren't everything.  Lots of trans guys voluntarily get surgeries that don't preserve nipples at all and just get them tattooed on or live without them, or just consider the loss of a nipple or two to be an acceptable risk.  But me?  I like my nipples.

It's not that all top surgeries turn out bad, and I've seen lots of great ones, nipples and all.  It's just that I'm almost 100% sure that mine will not turn out OK, and it won't even be the surgeon's fault.

I have dermatillomania, and every imperfection on my skin winds up being gouged out deeply and quickly.  Recently I had a bedbug infestation that resulted in me having scars all the way up my shoulders and on my back from obsessively digging my nails into myself, and scabs are among the worst offenders.  So every recent top surgery I see I wind up zeroing in on the scabbed-up nipples, the lengthy incision scars, and think "What if this were me?"  A slightly misshapen nipple on most trans guys will heal and probably even correct itself.  There is no way that this would correct itself on me.  I won't be able to leave it alone.  And if I wind up with a less-sensitive spot, as some guys do, I'll wind up beating on it until it dies and falls off.

If you aren't in the same situation I am, it's hard to understand how confident I am in this risk.  I got a tattoo once, and was so proud of myself for not tearing the scabs off, yet the tattoo artist was able to find several areas where I'd clearly gouged it without thinking, even if I didn't notice I was doing it.  Believe me when I say that it's way better for me to avoid surgeries of any kind unless I absolutely need them.

This is all based on a huge shift in priorities.  Back when I started HRT, there was a myth going around that it shaved ten years off your life (there's no evidence of this).  That was an acceptable risk for me back then.  As I get older, my focus has shifted from passing at all costs to focusing on my bodily health.  This was a natural shift:  I don't have difficulty passing anymore, so trying to pass further is no longer a priority for me, not at the cost of my health.

And unfortunately, virtually all of the transition related healthcare I was continuing to get--the hormones, the binding, the possible top surgery--was damaging me in some way that did not make up for the amount of good it did.

Happy trails,
-- Jackson