I want top surgery without going off (MtF) HRT?

[VioletKnight]

So I've been transitioning for almost 2 years, and overall I enjoy the effects. I feel much more calmer, my genital dysphoria has been greatly reduced, my skin actually feels like it belongs on me, and my face has become more feminine and soft (though I still wish to get surgery for that).

There's only one problem, or should I say 2. I really really don't like having breasts. t's been Isomething that has concerned me for a while but I tried not to pay too much mind to it. At first it was mostly annoying, but they've grown to a point where I'm incredibly uncomfortable having them. I hate how they feel, how they look, I hate having to wear a bra and the thought of other people noticing them makes me livid. I though I'd get used to them but now I'm genuinely dysphoric to the point where I feel like chopping them off, and it's making me I'm question whether "non-binary" describes me better than transwoman.

I'm currently taking Spiro while lowering my estradiol (and eventually temporarily going off it) but I don't think going off estradiol will work long term since we need a sex hormone for bone health and mental cognition. I've been off estradiol a few times due to failing to fill my prescription and ended up being incredibly emotionally tense. I heard of some other options like raloxifene but I don't know if my medical provider would be willing to prescribe it, or if it is a decent substitute for estradiol outside of bone density (though having a less feminine body might have to be a tradeoff). Plus there's the issue of sagging, but I don't know if it'll be too bad because I'm still relatively small.

Anyhow the only option I have is to get top surgery, (potentially a full mastectomy to remove as much tissue as possible). I just don't know if any surgeons would be willing to preform it, or if my insurance will decide to screw me over and take away my pills if I even discuss it with them. Things like cost will be an issue (if it costs less than FFS I think I'll do it ASAP)

[Dena]

It's possible you are part of the non binary but there are many more questions that need to be answered before you could make that determination. The trick with insurance is therapy. if you can provide the proper letters, a surgeon would preform the surgery and insurance will pay for it if it's covered under the policy. As for staying on HRT, that will be determined by the surgeon. Some surgeons require a month off HRT, others may allow you to remain in Spiro while others may allow you to stay on HRT until just before surgery.

There is a warning about this. We have a member who had her breast removed because it was difficult living as a women. She has now returned to the feminine role and regrets having her breasts removed.

[VioletKnight]

It's possible you are part of the non binary but there are many more questions that need to be answered before you could make that determination. The trick with insurance is therapy. if you can provide the proper letters, a surgeon would preform the surgery and insurance will pay for it if it's covered under the policy. As for staying on HRT, that will be determined by the surgeon. Some surgeons require a month off HRT, others may allow you to remain in Spiro while others may allow you to stay on HRT until just before surgery.

There is a warning about this. We have a member who had her breast removed because it was difficult living as a women. She has now returned to the feminine role and regrets having her breasts removed.

Well that's not my problem. I still want to be a woman, just one with a very flat chest. But if she's willing to tell her process I'd appreciate it.

Going off HRT temporarily is not an issue either what I was worried about is whether I'd have to go off it permanently.

[Dena]

There is a gene that has a very high risk of breast cancer. Should you have it, you might be advised to avoid estradiol or have a mastectomy. On the other hand, many of us are small breasted and if you are overly large, a reduction might be appropriate. In my case, I am happy to have breasts but I am comfortable with the fact they are about a B cup. They are big enough to be noticed but small enough not to be a problem.

You probably would be asked to quit HRT but a reputable surgeon would question your motive for HRT and breast removal. They might require a therapist letter before considering that type of procedure.

[PurplePelican]

I'm going to be a little less friendly than the other previous poster.. But, you took hormones with the knowledge that they can and do cause breast growth. I'd suggest some serious therapy is required.. You'll need it to have a hop of getting anyone to sign off on your surgery as being medically necessary.

Complete detransition would be easiest rout to achieve a flat chest.

[VioletKnight]

There is a gene that has a very high risk of breast cancer. Should you have it, you might be advised to avoid estradiol or have a mastectomy. On the other hand, many of us are small breasted and if you are overly large, a reduction might be appropriate. In my case, I am happy to have breasts but I am comfortable with the fact they are about a B cup. They are big enough to be noticed but small enough not to be a problem.

You probably would be asked to quit HRT but a reputable surgeon would question your motive for HRT and breast removal. They might require a therapist letter before considering that type of procedure.

I don't know if I have the gene (testing is expensive) though I do have family history of breast cancer. But I hear that they only would do it if you're old and already have children.

Would getting an orchiectomy be practical to do first? I could then claim I'm detransitioning (and not have to worry about being off Antiandrogens), and later go back on estrogen when the procedure is finished.

[Dena]

If you have a family history, the genetic test might be covered by your insurance policy as might surgery. As for an Orchi, I am not sure if that surgery would be preformed without attempting to use a blocker first. One of the great advantages of blocker & estradiol therapy is it allows you to test drive feminine hormones before you make a final decision.

When I transitioned, blockers weren't available so testosterone was overpowering my HRT prior to surgery. I didn't realize this was the case because I though having the correct body ended my dysphoria. Only years latter have I come to understand it was removing testosterone that caused the mental change. Possibly some of my sisters discovered after surgery that they didn't like the feminine chemical balance and had transition regret as the result.

The rules seem to be constructed to get in the way of what you want however there has been much though put into them and they exist for a reason. Your wants and needs will change in the transition process that the rules minimize the chances that you will regret your decisions.

[VioletKnight]

If you have a family history, the genetic test might be covered by your insurance policy as might surgery. As for an Orchi, I am not sure if that surgery would be preformed without attempting to use a blocker first. One of the great advantages of blocker & estradiol therapy is it allows you to test drive feminine hormones before you make a final decision.

I have been on blockers for the same time I've been on Estradiol, and am still taking them and enjoy the effects. I dont dislike any of the effects of estrogen except having breasts.

Lowering estradiol after a few days reduced the soreness which was one of the things that bothered me, so it's not as bad but still not desirable. I usually wear sports bras which used to sufficiently flatten me, but that's starting to change after 2ish years, which is why it's bothering me more now.

[Transfused]

So you want to be a femboy?
Body and face of a woman minus breasts?
Top surgery is a serious thing.
Renee Richards had her breasts removed when she did a first transition attempt in her 30s. After 5 years of HRT she stopped and detransitioned, later retransitioned and ignored her earlier experiences. Result is that she regrets SRS and lives as a woman who has had a bitter post-op life.

Give it lots of time and do nothing hasty.

I had to get used to having breasts too in the beginning but I could never imagine having a flat chest. I'm even saving up for breast implants because my boobs became part of me.

[VioletKnight]

So you want to be a femboy?
Body and face of a woman minus breasts?

Basically, though I don't think femboy is the accurate word, because I've only heard that to mean cis male crossdressers. I'm not particualrly feminine or wear dresses anyhow

The best way to describe what I'd want is an intersex condition, most likely XY gonadal dysgenesis/Swyer Syndrome

Due to the inability of the streak gonads to produce sex hormones (both estrogens and androgens), most of the secondary sex characteristics do not develop. This is especially true of estrogenic changes such as breast development, widening of the pelvis and hips, and menstrual periods.

I need sex hormones for health and neurological reasons, but I'd rather not have to take them.