Introduction to Top Surgery, Transmasculine, Transfeminine and Neutrois procedures

The process of learning about Top Surgery, and making your way around all of the information on this site can be overwhelming.  Hopefully this summary page will serve to provide an overview of the different sections of this website and help you make your way through the learning process.  Think of this page as something of an annotated site map – and then click on the links to access the information described below.

At its core, Top Surgery is defined as a variety of procedures which alter the gender-related characteristics of the chest to appear less like the gender identity that the patient was assigned at birth.  For transmasculine individuals who were born with bodies that formed breasts, this means significant reduction or removal of breast tissue, which usually results in the chest appearing more masculine.  For transfeminine individuals, this usually means a breast augmentation procedure to allow a chest that formed with a male appearance to then achieve the appearance and proportions of a well-developed female chest.

To those within the world of transgender health, the description above is self-evident.  However, to others (for example, family members who are not transgender themselves but are expressing support through educating themselves about transgender issues) it might require even further explanation. Wonderful resources on the internet explore the experience and challenges of being transgender, which is a discussion beyond the scope of this website.  This website deals with components of the surgical portion of a transition from the gender the world assigned to someone, to the gender an individual has as their identity.  This gender assigned at birth and gender of identification are not the same for the 1.5 million or more Americans who are transgender.

 

FTM Top Surgery

“FTM” Stands for “Female to Male”, and refers to individuals who were identified as female at birth (by the Obstetrician looking at the formation of genitalia), and whose bodies continued to develop with female characteristics but whose personal identification is definitively separate from the female gender.  FTM is still a very popular and used term, but perhaps a better term would be transmasculine because it respects that the endpoint might not be definitively male.  This is because some individuals identify as male, but others identify as gender neutral, but generally all individuals in this category share in common that the presence of breasts (and the fact that the world identifies them as female) is uncomfortable.  The discomfort of being put by the world into a gender category that one feels doesn’t belong to them is called Gender Dysphoria.

For someone thinking about FTM Top Surgery (also called “transgender mastectomy”), there are several considerations.  For one, there are numerous procedures available, and the decision among the procedure types can feel overwhelming.  We have put a description of the major types of FTM Top Surgery procedures on this summary page, and on a separate page there is a description of how you choose your FTM Top Surgery Incision based on your body’s anatomy as well.  And if you want to geek out (like Dr. Mosser himself does) and dig into how these procedures actually work, we have digitally animated videos about FTM Top Surgery Techniques here, with an ever growing library.

Top surgery is not the only FTM procedure or the only transgender surgery we do – it is simply the most requested.  There are also transmasculine procedures available and even trusted referrals to other providers with high standards for bottom (genitalia) surgery as well.

Once you have narrowed down your choices, getting a consult is a good idea, and of course all the while as you get closer to surgery you can learn about what you need to know before FTM Surgery and also while recovering from FTM Surgery.

FTN Top Surgery

“FTN” stands for “Female to Neutrois”, and refers to individuals who were identified as female at birth (by the Obstetrician looking at the formation of genitalia), and whose bodies continued to develop with female characteristics but whose personal identification is definitively separate from the female gender. Neutrois is an identity used by individuals who feel they fall outside the gender binary and don’t identify as either male or female. Neutrois is understood as a non-binary gender identity that falls under the genderqueer, non-binary, gender expansive and/or transgender umbrellas.

The discomfort of being put into a gender category that one feels doesn’t belong to them is called Gender Dysphoria. Being assigned female at birth but identifying outside of the binary can be painful. Some folks may seek surgical options to manipulate specific characteristics of their body that they feel best represents their gender identity.

For someone thinking about FTN Top Surgery (also called “transgender mastectomy”), there are several considerations.  For one, there are numerous procedures available, and the decision among the procedure types can feel overwhelming.  We have put a description of the major types of FTN top surgeries. The fishmouth FTM/N Top Surgery Procedure provides a non-traditional scar location, and more of a gender neutral result.

Top surgery is not the only FTN procedure – it is simply the most requested at this time.  There are also other surgery procedures available which we can explore more in depth during a consultation in addition to trusted referrals to other providers with high standards for bottom (genitalia) surgery.

MTF Top Surgery

For MTF Breast augmentation, there are a few decisions that transfeminine individuals need to make as well, which range from implant type, size, location and incision.  These MTF Top Surgery Options are discussed here.

As in the case with transmasculine patients, there is information you should know before surgery, as well as during the MTF Top Surgery Recovery as well.

And finally, many transfeminine individuals would benefit from other procedures, such as transfeminine procedures and also possible referrals to trusted specialists who perform facial feminization procedures or bottom surgery (genitalia) procedures as well.

MTN Top Surgery

“MTN” stands for “Male to Neutrois”, and refers to individuals who were identified as male at birth (by the Obstetrician looking at the formation of genitalia), and whose bodies continued to develop with male characteristics but whose personal identification is definitively separate from the binary male gender they were assigned to. Neutrois is an identity used by individuals who feel they fall outside the gender binary and don’t identify as either male or female. Neutrois is understood as a non-binary gender identity that falls under the genderqueer and/or transgender umbrellas.

The discomfort of being put into a gender category that one feels doesn’t belong to them is called Gender Dysphoria. Being assigned male at birth but identifying outside of the binary can be painful and some individuals may seek surgical options to manipulate specific characteristics of their body so they appear more gender neutral.

Individuals who are assigned male at birth but identify as neutrois may seek top surgery or other neutrois procedures. There are also other surgery procedures available which we can explore more in depth during a consultation. As well as trusted referrals to other providers with high standards for bottom (genitalia) surgery.

Although Dr. Mosser has not knowingly seen patients who identify as MTN, at the Gender Confirmation Center we respect and hold space for all identities. If you’d like more information on Male to Neutrois, here is a good starting point as far as resources you can explore.

Insurance Approval:

For transmasculine, transfeminie and neutrois folks it’s important to recognize that insurance is covering these surgical procedures increasingly these days. Therefore understanding this somewhat daunting process can be part of the challenge patients face.  We have laid out a full description of the transgender surgery insurance approval process for you.  In fact, we have a full-time member of our team called our Insurance Concierge, who will pretty much take this off your hands entirely and, keep you informed as she works toward getting your insurance approved.

Though it only scratches the surface, hopefully this short overview has given you an idea of the resources we focused on when making this website.  We believe in you, and we believe in the transgender, non-binary and gender expansive journey.  Please reach out to us via the contact us page for anything we can do to help.