surgery from top to bottom .

Disclaimer: Article discusses gender confirmation surgery (GCS), hospitals and trauma.

I, like many, believe that transness is a spectrum. And that many question their gender identity and decide they aren’t trans then reconsider in future, or vice versa. Or may never fully know. And that’s okay.

But regardless of how certain or uncertain they are around their gender identity; many consider surgery to move towards feeling their authentic selves and/or reduce symptoms of gender dysphoria. Being ‘trans’ means existing within an umbrella, one where certain identities may resonate.

And we have discussed hormone replacement therapy in a previous article (, it is only fitting to move onto surgery now as trans folx seeking medical transition typically start hormones before undergoing surgery.

What options are available? Depending on the country and healthcare system, some procedures may be covered by the state, though many remain privatised. Facial feminisation surgery (FFS), for instance, is generally patient-funded. Meanwhile, top surgery for those reducing chest size is covered by public health in some countries, albeit waiting lists are often long and the process is heavily bureaucratised.

There is a lot of relevant information about surgical options online, some of which are listed at the bottom of this article. However, as someone who isn’t a healthcare professional, what I offer to you are my own experiences.

In June 2020, I underwent breast augmentation surgery in the UK. I am fortunate enough to have a student loan to fund this from, opting for private healthcare to reduce medical trauma, something that has deep roots within me. Also, due to extensive waiting list times with the National Health Service, I chose to go private to reduce gender dysphoria in the meantime, encourage positive results from surgery (based on age) and improve my quality of life. It was expensive but worth it to me, even if I am still struggling financially, almost a year later, as a result of it.

Regarding GCS, however, I rest at a crossroads. The cost of GCS from the private sphere is extortionate and unaffordable for me, and hospital trauma is at a place where I would not feel comfortable being an inpatient in an NHS ward for several weeks. And despite thinking about the issue in depth for many years, I am still unresolved about whether bottom surgery is right for me. I have a dysfunctional relationship with parts of my body, something that makes that decision more complicated.

So, where does that leave me? Somewhere I’ll probably be for a while, assuming I don’t reach a sudden and unexpected epiphany soon. Surgery in its various forms is something that many trans folx contemplate, consider and research due to its irreversible nature. While some remain steadfast on their need to undergo it, others negate some types for others (or none). And some lack the choice as a result of limited affluence and/or mitigating health factors that prevent them from being cleared for surgery.

Evidently, then, gender-related surgeries are a complicated topic in the modern world. One whose dimensions vary based on the person debating them. And one whose public funding should be further supported.


Gendered Intelligence Guide:

NHS Guide:

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