I honestly have no idea. If I added up the pros and cons, HRT would win for simply the amount of desirable effects (which is pretty much all of them). But top surgery is no small deal either. Be able to run around shirtless, no more binding, no more manicles (yes, that is what I am calling them), be able to just go swimming and not think about it, feel confident in male change rooms... Yeah, it's tough. It can't come soon enough, that's for sure.