I'll start by saying that I don't think I have surgery addiction, but I have to be honest and say that I'm not sure I'm doing very well at judging where the line begins and ends.

I didn't get the sort of results I was hoping for from T, and I'm sure that a large percentage of trans guys could say the same; you always want to be a little more handsome, a little taller, a little more well-defined, etc.

I am just having a hard time trying to figure out if the changes I want are normal, selfish/irrational, or going too far.

For example, I work in an office-based role where I do a lot of talking over the phone. My voice NEVER passes for male, even with my very male name. I've been on T and doing voice work for six years now, and I know that shiz isn't going to change. Getting misgendered over the phone just ruins my whole day, and it's killing me inside.

So here's me saying 'Obviously I need vocal surgery'. Oh how it would make everything in life better!

I can't wear male clothes because I was 'gifted' with an hourglass figure and my hips are ridiculous (can't button a suit or jacket, pants don't fit, everything looks feminine). Obviously I need sculpting to change that!

My face is sweet, round, and soft, and if I don't leave stubble on my chin people will misgender me; obviously I need facial masculinisation surgery!

Now I'm not about to run out and get all of these things done; cost and time are just too prohibitive, but that doesn't stop me from wanting or thinking about them.

I know in the past I've looked at women with their triple-E fake boobs, botoxed lips, tattooed eyebrows, and razor-sharp noses and rolled my eyes, but am I any better? At what point do these visual changes exit the bounds of medical treatment for my condition?

It's not keeping me awake at night, but I have been thinking about it a bit. What point did you stop at, and why? Are there any guys here who went for more cosmetic treatments like chest/hip sculpting, vocal surgery, etc? Did you find that the results were everything you wanted, or is there still more you feel like you need to have done?

I'm a tiny bit worried that if I do decide to pursue these options down the line, it'll never be enough.

Thoughts?

I would suggest that the medical treatment would exit the bounds for the treatment of your condition when you 'pass' as male most of the time, including maybe over the phone. After that it all becomes vanity.

Isn't T therapy for gender transition about appearing male to yourself and others? If it doesn't succeed often enough, then the treatment hasn't reached its goal.

I'm a bit worried about whether my voice will drop enough to sound male. According to studies, 98% of FTM's do pass as male within 10 years. Outside the telephone test, do you pass as male?  It seems to me that most people judge a person's gender by using very narrow criteria, and one of those criteria does NOT include whether you have an hour glass figure and a round soft face. Mostly it seems to me to be by voice, lack of breasts, and a beard would probably tilt it into male domain without any other features being considered.

The question is: what criteria of T therapy success did you set yourself?

I think cosmetic surgery can be a necessary thing to improve a person's self esteem; as long as they don't get the same type of surgery over and over again because they saw a flaw other people can't see. And tried other ways to improve their self esteem like therapy; first.

I also think when everyone uses the phone it never sounds like their usual voice. It somehow always distorts it no matter how good the connection is. As long as your voice sounds male normally that's what you should try and focus on.

Another thing; you can be a man who happens to be trans and develop body dysmorphic disorder. Do other people see the flaws you do or not?

You can't wear male clothes? Are you talking specifically about perfectly-fitting suits? Because there's a lot of male clothes that you can fix up if you need to - easier doing that than getting surgery. There's also weight loss/fat loss - most of the hourglass comes from fat deposition, have you pursued that avenue fully before the idea of major surgery?

I can appreciate the concern over the voice. It's a major problem for some without much you can do about it by yourself if T didn't lower it, and if surgery can fix it I can see why that would be desirable. However, having taken a look at the "before and after" results vids for thyroplasty, seems like the results are pretty variable, and nobody seems to end up with a super-masculine voice, if that was their goal.

Where do you draw the line? Wherever you want. It's your body and your money. Personally I'm not a fan of surgery so I think I'll be drawing the line with the "essentials", but then I am lucky enough not to have to consider the voice issue etc. if I did and it was causing me massive distress I'd probably consider more. The whole reason I'm on HRT and considering the knife in the first place is the depth of distress caused. 

A surgical addiction would be when nothing is ever good enough. I have seen people undergoing a third and fourth FFS surgery because they are unable to accept the feminine face that they have and are targeting perfection. Few people in the population are 100% masculine or feminine and tend to have a mix of both traits so it's when you want to eliminate all of the traits that it becomes a problem.

CIS men when buying a dress suit rarely buy directly off the rack. In a better mens shop, you select the suit you desire and corrections to the fit are determined. You pick the altered suit up latter after the corrections have been made. This cost less than a custom suit but it still produce a well fitting suit. This is because all men are not created the same but a proper fitting suit covers the fact.

As for voice, speech therapy isn't for MTFs alone. I have heard voices at 250HZ which is well into the feminine range that sounded masculine. On the others side, I have heard very low voices that sounded feminine. Pitch is only part of what we used to gender voices and the remainder is how you use it. I have worked with FTMs and they have been able to make major changes to their voice just by using it correctly.

Look for the simple fixes first and often you will discover there is more than one way to reach your goal and it doesn't involve surgery.