Top surgery or HRT first?

[JohnAlex]

What do most transsexual get first, top surgery or HRT?  and why? 

I've seen/read about different people getting different ones first.  I'm wondering if it makes a difference which is started first?  Or which is better to start first?

And for anyone who hasn't had either top surgery or HRT (like me), which would you rather do first?

[Linus]

This is one of those "it depends" questions. I have an FTM friend who had it done prior to starting T while others go the other route. I think most people do the HRT first largely due to costs. Additionally, often there is a requirement by some surgeons that you meet some kind of standard to ensure that your chance of recidivism is truly low and that this isn't a mistake for you.

For me, I wanted the HRT first to ensure that I wasn't mistaken in what I felt. After nearly 3 years on T, I'm now looking into surgery and should meet the standards for what's required as far as GID standards are.

[Nygeel]

When I started to think of myself and my transition I thought I would have top surgery and not go on testosterone. I thought that top surgery was what I needed to make myself happy. Then I went through a long period of researching testosterone and getting to know myself better and decided that I did indeed need testosterone. Since starting testosterone the dysphoria around my chest (which is fairly large) has decreased. I'm considering top surgery but since my chest is a secondary sex characteristic which is getting a bit smaller, and isn't something easily visible the need isn't there.

It's a matter of figuring out what bothers you the most. What makes you most uncomfortable.

[Tad]

In my province - you do HRT first. There is only one person in the provincve that can sign off on top surgery.. and he can take a year to get in to see in the first place, and he does HRT first (most docs won't prescribe HRT - so you're waiting for his go ahead).. Top surgery he'll start thinking about 6ish months it seems from what I've heard after you've started seeing him. After you got your referal it's likely another 8 months before you can get in to the top surgeon.. so top surgery first is not really an option here, unless you're willing to wait a couple of years potentially before you start T.

He says my second appointment with him he'll write the referal. Second appointment is in July (first was in Decemeber).. then after that I might be waiting as long as 8 months for surgery.. so it was a no duh moment to go for T first. 

I likely would have preffered top first because I was a little iffy about T, and already passed well.

[r e m]

Everyone I've met has done HRT first because you can get it at a younger age where I live. I've heard top surgery looks a lot nicer on guys who have been on T for a couple of years and and have male fat distribution and such.

[Michael Joseph]

Like what R.E.M said, its better to get top surgery after because the surgeon can have a better idea of whats going to happen with fat redistribution and stuff. But, i have seen a few guys that have gotten top surgery first, and it ended up just fine.

For me personally i also am going on hormones first because as much dysphoria as my chest gives me, i can bind. I cant deepen my voice or grow facial hair or any of that stuff without T and for me that is what i personally need. Plus i need to save up for surgery.

[wheat thins are delicious]

If I could have done top first I would have, but since I couldn't I did hormones first. 

[xAndrewx]

I started T first because I can't afford surgery yet. Below is another part of my reason for doing T first.

I cant deepen my voice or grow facial hair or any of that stuff without T and for me that is what i personally need.

[wheat thins are delicious]

I started T first because I can't afford surgery yet. Below is another part of my reason for doing T first.

The need for secondary sex characteristics is my second reason like you.  I'm not sure how the situation would be different if I could have afforded top surgery first.  Probably no different because at the point I was so dysphoric by being seen as a female all the time.  No matter how hard I tried to look male I didn't have the characteristics needed to help me pass. 

[PandaValentine]

In my personal experience with being on T (and not having top surgery yet) is that it can worsen your dysphoria. It just felt like testosterone is out of the way, now I want my top surgery but can't quite afford it yet. My body was changing, but my chest was staying the same, which really hurts. However I agree with what others say about the changes of testosterone that are needed to pass, unless you are one to not care so much about passing...surprisingly trans guys like that exist, I don't know how they do it! Another problem with starting T first is if you're having trouble binding. Like me personally, I may be small but they never bind to how I want them, so I got all these changes and chest that's not really matching. So I have to shave my face and wear pants so I don't have to shave my legs and look like some sort of naturalist woman. Honestly in my opinion, both ways got ups and downs. I don't personally know if there are benefits of doing T first for the surgery, except it does help you build muscle easier, and it's always better to have a more muscular chest for surgery, also I've seen pictures and it makes the chest look better than with no muscle gain.

[JesseO]

I am not on either and I would prefer top surgery first. I have felt this way for about 3+ years. However, I am one of those extremely lucky people who is able to have a portion of their surgery covered under insurance (if I can find a surgeon, that is). The catch is that I need to be on T for 12 months previously. Therefore, it just is not reasonable for me to pay out of pocket for top surgery before T when I could have a lot of my costs taken care of through the insurance I pay for every paycheck. For me, I'd prefer top first, but that's not going to happen.

[Elijah3291]

In my personal experience with being on T (and not having top surgery yet) is that it can worsen your dysphoria. It just felt like testosterone is out of the way, now I want my top surgery but can't quite afford it yet. My body was changing, but my chest was staying the same, which really hurts.

agree, my chest dysphoria has gotten worse, because I can see how much T has changed my arms and shoulders and I want to show it off, but I still have these gross things flopping around.

I think most people start HRT first because it is cheaper and its good to let yourself grow a bit before surgery, pec muscles etc

[robokot]

I'm very big chested (G cup) so I would like to get surgery first, I'm not binding because it causes me too much discomfort, I just wear baggy clothes and pretend I have a flat chest

[Ryan]

Something that may be worth knowing is that pre-T, your skin will heal better due to the estrogen. However, post-T you're able to build muscle far easier, meaning you can give the surgeon something to work with and get a better scar placement.

[Logan1986]

Everyone I know started HRT first but I think it was mostly due to the fact that starting T is a much easier and cheaper process. If I had been able to afford surgery from the beginning I think I would have done that first.

[Darrin Scott]

My thing is though, I'm larger chested. I don't get completely flat with a binder. I think I'd look a little weird with a deep voice and facial hair and a large chest. I'd rather get the surgery first.

[Logan1986]

My thing is though, I'm larger chested. I don't get completely flat with a binder. I think I'd look a little weird with a deep voice and facial hair and a large chest. I'd rather get the surgery first.

I thought the same but it worked for me until I had surgery. A bio guy I work with has a big chest (i'd guess at least a D) and nobody thinks twice about it. His one feminine trait isn't enough to negate his masculine ones. Although like I said, If I could of I probably would have chosen surgery first too.

[quinn]

Because of the cost, I'm going to take T before I get top surgery. I would rather get surgery first, if I could, because my chest bothers me a lot. I have PCOS, so I already have a somewhat high level of T (I even have a bit of facial hair, it's not that noticeable because it's blond-ish and practically invisible because I also have a light skin tone, but it's enough that I have considered shaving so I'll look more female until I actually start transitioning. It's so weird to me that for the next few months I have to pass as female, but then I'll be taking T and I'll have to try to pass as male...) so I could probably pass if I had surgery first. My voice isn't very deep, but I can make it sound low enough that I could pass if my chest was flat.

[N.Chaos]

Something that may be worth knowing is that pre-T, your skin will heal better due to the estrogen. However, post-T you're able to build muscle far easier, meaning you can give the surgeon something to work with and get a better scar placement.

That's very comforting for me to know, I'm one of those oddballs that doesn't plan on going on T for various reasons. I just hope I'm able to find a way to get top surgery without being on it, but unfortunately that's going to be a long ways off anyway. I still don't have the money for a therapist, letalone the money for a car to get to a therapist.

[Superrad]

My chest is (thankfully) relatively small and though it occasionally bothers me, I think other issues are more pressing. That and the fact that I don't have anywhere near enough money for top surgery.