A person’s general body shape is largely defined by their skeletal frame, as well as their distribution of muscle and fat. Because some folks assigned female at birth (AFAB) tend to have more curves and a smaller stature, many transmen and non-binary transmasculine people desire a physical transformation to masculinize or neutralize these traits. Though it’s possible to attain a less feminine body type through various surgical and lifestyle changes, it’s important to understand the statistical differences between someone who has undergone a full estrogenic development (AFAB puberty) and someone who has gone through a full androgenic development (AMAB puberty) in order to formulate realistic goals based on how your body has formed.
Figure B is of an adult who experienced an estrogenic development, figure A is of an adult who went through an androgenic development. You can see that the bone structure of figure A is narrow. Hormone replacement therapy such as testosterone can’t change the bone structure of the body, and surgical modification of the pelvis comes with significant risks based on the current surgical techniques. Therefore, to obtain a more neutral or more masculine form, transmen, non-binary and gender expansive folks generally seek body contouring of the overlying soft tissues (fat).
Dr. Mosser doesn’t require patients to be on hormones in order to receive top surgery or body contouring. However, being on testosterone for a year prior to body contouring may help your results, as this would allow some natural fat redistribution to occur. It’s important to note that the bony structure of the pelvis as featured in figure B is unlikely to be affected by testosterone, and body contouring is attributed to the removal or redistribution of fat and does not relate to altering of the boney structure.
During puberty, the production of hormones increases, which usually causes rapid physical changes usually occur. This results in the development of secondary sexual characteristics that society labels as masculine or feminine.
Testosterone is produced by everybody at different rates. These differing rates are responsible for many physical differences between estrogenic and androgenic development. Folks assigned male at birth (AMAB) can produce as much as 10 times the testosterone of the average person assigned female at birth (AFAB).
Testosterone levels affect how fat is metabolized and carried. AFAB people are more efficient in storing fat and are prone to weight in their hips, butt and thighs. However, AMAB folks typically have lower percentages of body fat and are more likely to gain weight in their upper body, especially around the waist and abdomen.
Hormone replacement therapy (HRT) for testosterone can induce broad shoulders, an expanded chest, increased muscle mass, increased bone mass, thicker skin, more angular eyes and face, deepening of the voice, facial and body hair growth, etc. Despite the positive effects of hormone therapy, changes in body fat redistribution caused by HRT can sometimes not be enough to combat feelings of gender dysphoria. This is why many of Dr. Mosser’s patients have chosen to move forward with a gender affirming body contouring procedure.
Someone who went through a full estrogenic puberty uninhibited by hormone blockers has on average 10% more body fat compared to someone who underwent an androgenic puberty. The difference in fat deposition leads to varying degrees of waist-to-hip ratio (WHR). Often, the WHR for someone AFAB is 0.65 to 0.80, whereas AMAB adults are often within the 0.85 to 0.95 range. Depending on the amount of time an individual lived as their assigned sex and the amount of fat they deposited in certain areas, the extent to which these soft tissue characteristics can be changed varies. Approaches to body contouring for transmasculine and non-binary folks should aim to obtain a WHR range between 0.85-0.95.
Below you’ll see that the androgenic body form featured in figure C has a concave/flat appearance. Body contouring of the gluteal region for transmasculine folks would aim to remove the fullness of figure D so they have an appearance more like figure C.
For folks AMAB their waistline is significantly higher than those AFAB. Lifting the waistline through liposuction of these areas can have a significant positive impact on the fit of masculine clothing. When done appropriately, contouring will decrease the hourglass silhouette featured in figure A so that the body looks more like figure B.
While no two shapes or figures are ever the same, most AMAB body types can placed into one of the three categories below. Use these shapes to help guide your decision-making around body contouring. If you’d like, schedule a consultation with us so we can learn more about your gender-affirming body contouring goals.
V-shaped folks can easily shift from being incredibly lean or very muscular. They tend to have very broad shoulders, a narrow waist and narrow hips. When V-shaped people gain weight, it tends to be around the abdomen, but it can also occur on the buttocks.
People with apple-shaped bodies tend to be shorter and rounder than those in the other body types. They carry much of their weight around their abdomen, calves and ankles.
Males with a rectangular frame usually appear very muscular. They are prone to rounded, protruding chests and rectangular torsos, as well as thicker arms, thighs and calves. Rectangular-shaped body types sometimes carry weight in the hips, buttocks, upper back and stomach.
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