Trans Parent “Top” Story, Part 1 of 2

One of those cute aspirational trans men!

[Lengthy post for the keenly interested]

For new readers, I’m the parent of a young adult (24) who identifies as genderqueer and transgender. Link was assigned female at birth. I would say they were raised culturally female (although less gender-boxed than most), but by age 16, did not relate to being a girl or woman. Transgender people who lean to the male side can be anywhere on the spectrum of masculinity – born in the wrong body and wanting to become a man, staying in the same body and taking on a male identity, focusing on externals such as clothing or gestures, modifying the body with gender-related surgeries, taking various levels of testosterone to get the desired effects, or any combination. In Link’s case, they began with binding their chest to make it look flatter and to not be mistaken so often for a girl. Link explored their male side in terms of clothing and appearance, interests, friends, love and sexuality. Two years ago they started taking a low dose of testosterone which caused permanent masculinization, with changes to their voice, build, body hair, and emotional “timbre.” They decided the next step would be top surgery: mastectomy to gain a male appearance.

A binder (compression shirt) and how it looks with clothes over (not Link)

Why Link wanted top surgery

  • Identifies as genderqueer or male (Link prefers they/them as pronouns but will answer to he/him for those who need the simplicity)
  • Usually misgendered and seen as female. This causes serious distress because of their gender dysphoria (the diagnosis of being mismatched to their body)
  • Wanted androgynous appearance. Link had a DD cup size which always drew attention and completely obliterated any chance of appearing male.
  • Having breasts at all – unwanted appendages. Most trans men think of breasts as not belonging to their bodies (or to the bodies they want) and being extraneous.
  • Binding, discomfort and medical issues. Link used compression tank-tops (binders) to cover and flatten the chest area. They have several layers of extreme compression fabric. For larger sizes, they are only partially effective. They can cause bruising, rashes, breathing difficulties and even broken ribs. They limit your movement and don’t allow for fitness activities. Over years, they can seriously impact health. Yet because of dysphoria, it is impossible to go out without one.
  • Not just about what clothing they could wear, but romantic and sexual attractiveness and self-identity
  • Knew the surgery wouldn’t “solve everything” but would solve some things

Top surgery for transgender people is not the same as mastectomies for women who have had breast cancer, pictured here. See the contrast in pictures below.

How a lot of people I know reacted to the idea of top surgery (even some “LGBTQ friendly” ones):

  • We should love and accept our bodies as they are.
    • This is an ideal, but not the norm for most people! If it’s hard for the average person, it’s that much harder for someone with a gender identity disorder.
  • They must hate themselves.
    • Transgender people want to live in a society that appreciates gender diversity and accepts them as they are or want to be. If that society existed, they wouldn’t hate themselves.
  • They are mutilating themselves!
    • Mutilate means to disfigure or permanently harm. When a trans person is able to go from a detested state to a desired state through surgery, they are not disfiguring but reconfiguring, and healing from harm.
  • Trans men are anti-woman.
    • No, they are just not women. We aren’t obliged to hate people and things we are not.  I’m not a blonde; that doesn’t mean I’m anti-blonde. If I am a brunette and I colour my hair blonde, it doesn’t mean I hate brunettes.
  • Or anti-feminist
    • The majority of trans men were raised as female and learned see the world through the lenses of women, LGBTQ folks and other oppressed groups. Many trans men reject macho culture and are actively trying out a new model of manhood (or gender freedom) that bodes well for future equality!

I find attitudes toward appearance-related procedures contradictory. While most people I know have not had any such procedures, and some scorn them, they’re not uncommon either. And some have a medical component. For example, correcting an overbite changes one’s appearance, but will also help with jaw misalignment. Laser eye surgery means you don’t have to be seen with glasses, and of course, it corrects your vision. Women will often say they got breast augmentation or Botox not for their partners but “just for me.” It matters more if it’s forever (hair straightening might be seen as OK since it is temporary, while tattoos are not). But a lot of people draw a line between beautifying (for acceptance or approval) and changing one’s very identity – because isn’t the world easier to understand when one’s outward sex characteristics remain fixed?

What I thought of top surgery (as a parent):

  • At 16, I did think Link was too young and they should make an informed decision as an adult. The surgery was much less available 8 years ago and there was less information out there. I also thought that Link’s being genderqueer might be a stop along the way to becoming a man, and they might want to wait and create a bigger medical plan later. If I knew someone with a trans teenager now, I would probably advise them to start transition earlier. It helps you get on with your life. My caveat is that the young person needs to be mature and stable enough to comply with medical instructions.
  • Ideally Link would love or accept their own body as it is, and people would treat Link as they wish to be treated, but that is not even remotely a given.
  • Initially, I wished Link didn’t care what others said or thought. But no one is that stoic, nor should they be. We’re not steel people; words and looks and gestures scratch and dent and rust us. We care about the opinions of everyone around us, even “the general public” or online personae. Even more so when you are 16 or 24.
  • I became afraid of the health impact of Link binding their chest for years.
  • Eventually I saw Link as a new person whose body didn’t match their real self – they needed to make it right.
  • It was a logical step after two years of testosterone – another part of the transition.

My fears (as a parent):

  • It is major surgery and all surgery has risks
  • If the surgery was inept, corrections would be needed later
  • I didn’t know if Link would be able to find a trans-friendly family doctor for follow-up care
  • Maybe they would want to continue on and have bottom (genital) surgery – and that is really serious!

Example of top surgery (not Link)

What top surgery is:

  • Double mastectomy and chest reconstruction for a male chest appearance
  • The mastectomy deals only with the removal of breast tissue and doesn’t follow up by creating an aesthetically pleasing, male-appearing chest. That part is known as reconstruction or contouring and may have a separate cost or approval process.
  • There are 2 types of surgery depending on the amount of skin and tissue: peri-areolar (circum-areolar) and double incision. The former is for those with less tissue to remove. Those with more tissue will need the double incision technique.
  • Nipples are retained in place or grafted back on (often resized)
  • If the surgery occurs when the patient has been on testosterone for a while, they may have been dealing with new-male acne, sweat and chest hair under their binder
  • It is unlike mastectomy after breast cancer – for that, nipples are often removed and there may be less attention to the final appearance of the flat chest (did you know that about 45% of women who have mastectomies after cancer choose not to have breast reconstruction, live with flat chests, and are just happy to be alive?)
  • Top surgery is a day surgery and patients are released after a few hours!

OK, so that is my spiel. Next time I will detail Link’s specific surgery and what it was like for me as a parent, too.

What are your thoughts?

Note: all photos were taken from uncredited Internet sources. If you are the copyright holder of these images, please contact me regarding permissions or take-down requests.

Part 2 of this post is here.


  1. I think it is wonderful that you are so supportive of Link. You are the kind of parent that Wolsey wished he had (he lucked out with in-laws, but not parents).

    The bottom surgery for Wolsey/Jello went really well and was a lot smoother then expected (especially compared to a decade ago). If Link goes that way, just do your normal research and they will be fine.

    Oh, and if Link wants liposuction, just a heads up that was way worse then advertised, but successful :).

    • Link is only thinking of one more procedure, but bottom surgery is not in the plan. I’m not afraid of it like I once was, although I still do think it is very serious – in terms of risk, recovery and pain! But ya gotta do what ya gotta do. Would not have guessed about the lipo!

  2. I am sure the information you shared here not only will help many people understand this surgery and the reasons behind it but also be of great support to another person who is considering the same step. It is wonderful that you are so supportive of Link.

  3. Cynthis

    I can’t imagine the discomfort of wearing that binder thing if you have large breasts. Yikes. It’s generous of you and Link to share their journey. I understand you are doing it to help others, but it’s sad that people can’t be who they are and do what they want about something so personal without judgment. Best of luck and happiness to Link in the life they choose to lead.

    • I will pass that along. I am not sure why people comment on other people’s bodies – in public, and judgmentally. I suppose there is an element of surprise: “I didn’t expect to see someone who looks like that,” but when negative thoughts are shared aloud, it can only be rudeness, a wish to cause harm – or a warped sense of entertainment (creating drama).

  4. This was beautifully written, with a nice balance of facts and personal insight. Thank you.

  5. Mel

    We are super proud of Link and so glad surgery went well!

  6. Jo

    I’m a huge supported of bodily autonomy – the only person who should get to decide what happens to their body is the person living inside it. I do admire and respect the info you put out about Link and their way of dealing with life. I’m sure these posts are helpful to other genderqueer and trans young people and a great help to friends and family of young (and older) people looking to be comfortable in their own skin.

    • There are people out there who must think bodies can only be changed in accordance with popular opinion and they get the deciding vote! It is probably a function of age (and freedom from dysphoria), but I am so glad I can rest happy in my own body. It is a bit of a gift to feel that way regardless of one’s imperfections!

  7. Margie in Toronto

    Thank you for this – I cannot begin to imagine what you and Link have gone through. I won’t pretend to totally understand but I am glad that safe surgery is available and that Link has such a supportive family. I hope that the future (whatever additional surgery may or may not be chosen) is a happy one for everyone.

    • I am delighted too that safe and free surgery is available. In my world we talk about all this stuff so much, it is normal. Thanks for the good wishes! You’ll see in the next post that there is lots of happiness involved.

  8. Thank you for sharing this – like many, this is my only insight to this challenging surgery and process

    Am I to interpret that the ‘top’ surgery is of a higher priority as it’s a visual indicator, more so than any surgery in the genitals?

    • Great question, Sarah. I believe that whenever we encounter someone whose gender we can’t figure out, we consciously or unconsciously give them a complete visual scan, looking for indicators. If their gender doesn’t seem clear from their hair, clothes, makeup, jewellery and accessories (or lack thereof), I think we start zooming in on body parts: Adam’s apple, jawline, chest, hips, etc. So top surgery is a good way to “clear” that first visual scan, and be read as male. Another thing is that so many FTM individuals take testosterone and start living as male long before they get surgery. That must make it even more upsetting to still be read as female. At this point in history, most FTM people don’t get genital surgeries. It could be because of cost, availability or risks; or it could be that focusing on what’s visible to society matters most – depending on the person.

  9. Fiona

    I’m so relieved and happy for Link that things have gone so well. You are an amazing parent: to have been there so staunchly with support, concern for education and advocacy. No doubt there are enough battles for Link without having to fight one on the family front.

    I’m so grateful as a teacher to have had your blog. I don’t even know how I would have navigated such issues over the past few years, having had one young student now who has transitioned to a new gender over the course of 18 months. I certainly didn’t handle everything without some regrets but at least I have had some navigational points from following Link’s story. Thank you sincerely to both of you for being willing to share & educate others.

    • Thanks, Fiona. I think we all need a “hook” sometimes to care about an issue or even a group of people – sometimes the hook is a story, sometimes it’s knowing “a friend of a friend” or a “former co-worker’s nephew” or some other sort of bond. I know I get overwhelmed because there are so many causes and so many individuals to care about, but as a librarian, I still place a high value on awareness and education. When Link has choices to make, they often choose the path that is visible (like being “out” at work), in the hopes of modelling it for others.

      • Fiona

        I’m very grateful to Link. Please pass on my thanks. Indirectly, Link’s story has not just affected my dealings with individual students but also has shaped our written school documents. If we ever meet, Dar, we’ll have many notes to compare!

      • I am sure we’ll meet! It must be tricky creating policies for a private school. You might be more beholden to the wishes of parents, especially generous funders. On the other hand, with a couple of vocal supporters, it could be easier to get something posted – unlike going through a governmental process. Here in NS, teachers and school staff are supposed to ask for parental consent before using new names or pronouns for their students who are below grade 7 (about age 12). You can imagine the controversy on either side of the argument.

  10. Thank you for sharing this experience as a parent – I have no idea what’s in store for us as parents but it’s certainly conceivable that we might need this information for ourselves or for friends and it’s so important to be able to approach a situation like this with respect for the trans individual.

    • Thank you for saying so. You are the first person I’ve been in contact with who has ever acknowledged, “Hey, that could conceivably happen to my child.” Everyone else seems to think their child could never, ever be transgender. Like maybe they think trans people are grown from spores or something 🙂

      • Or it’s like a complicated flu, you’d only “catch” it if you’re near a trans person? I don’t know how people think but I operate on the assumption that of the experiences of the whole wide world, some unguessable number will come to roost in each individual. We have no way of guessing, only educating ourselves as best we can.

      • I will remember that. You are very quotable!

  11. My daughter is 12 and has been binding her chest for 2 years.
    We have gone to see a gender specialist and are going to explore hormone blockers to slow puberty down. She has been diagnosed with gender dysphoria. She still uses she and her given name right now, but usually passes as a boy.

    I am 100% supportive, but I am also afraid. She doesn’t seem to know exactly what she wants…but she hates having her period and breasts.

    Thank you for sharing your thoughts. I am trying to let go of my idea that a person should be able to find body acceptance. Perhaps it’s acceptance of who we are inside that is what actually matters.

    • I think puberty blockers are a good idea. Buys some time; reassures you it is not a passing phase. Oh yes, body acceptance. I used to think everyone should be able to come to terms with the body they got. If not, you were somehow not facing reality or not accepting of humankind’s differences and frailties. But now I know dysphoria is real. The remedies are not easy but they do exist. Ultimately we live in a society, so we are always judged by the standards of our culture (gender, beauty, etc.) so no matter who we are inside, we will always be judged by our appearance. So dysphoria should not be dismissed. I hope you have a supportive doctor and school system, although, sadly, that is a lot to ask. Have you read anything here:

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  13. Bennett

    I really wish I had parents as supportive as you.

    • Hi Bennett, If you are still living at home, I hope things improve. Meanwhile you can build your own family/community of like-minded souls, either in person or online…I wish you much happiness 🙂

  14. Xavier

    Thank you for making an outsiders perspective- I am trans and my parents are supportive, but I sent this to my mom to read because you explain a lot of things well.

    • I am glad you’re here on the internet finding resources and trying to reassure your parents 🙂 Link’s surgery was 13 months ago now, there were no complications and the healing went well. At work they choose to pass as male and it’s going fine.

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