A gender-affirming body contouring procedure is the surgical process of removing or re-contouring body fat to alleviate feelings of gender dysphoria or discomfort between a person’s assigned gender and the gender with which they identify. These procedures hopefully reduce how often a non-binary person will be misgendered. Much like non-binary top surgery, body contouring specific to non-binary appearing results is seldom discussed but is a viable option for those who are interested in obtaining a gender-neutral appearing body.
It’s important to note that when someone is non-binary, genderqueer, or gender-expansive, their body is by definition also non-binary (with or without medical intervention such as hormones or surgery). For folks who feel that their body shape doesn’t align or reflect their non-binary gender identity, this content will be helpful in determining what your options are.
Content note, body shapes: Although the following images and descriptions attempt to describe average or typical body shapes, the human body has many variations that extend beyond this set of parameters. This information is intended to shed light on how people assign gender to others based on body shapes. It is likely that someone’s body shape might look different than these images based on what type of puberty they went through, among a variety of other factors.
To understand what could be viewed as a “gender-neutral body shape” (appearing neither exclusively masculine nor exclusively feminine) we’ll first define:
Waist-To-Hip-Ratio (WHR) is the dimensionless ratio of the circumference of the waist to that of the hips. This is calculated as waist measurement divided by hip measurement (W ÷ H) and it can tell you your fat deposition. The WHR for those who went through estrogenic puberty is usually between 0.65-0.80, whereas those who went through an androgenic development are usually 0.85-0.95. Depending on the amount of time since puberty and the amount of fat they deposited, the amount that soft tissue characteristics can be changed varies. You can learn more about Wait-to-Hip Ratios here.
Since the patients Dr. Mosser has treated for gender-affirming non-binary body contouring procedure mostly identify on the transmasculine spectrum we’ll cover traditional ‘masculine’ forms, and then move onto what could be considered more gender-neutral appearing and find a balance between the two.
Someone who underwent a full androgenic pubertal period (assigned male at birth) will usually have the following characteristics that result in masculine body shape and are distinctly different than those who went through an estrogenic pubertal period.
A masculinizing body contouring procedure aims to remove some of the more ‘feminine’ appearing characteristics by:
When thinking about manipulating the aesthetics of gender, there are a few areas in which body fat will be removed or reduced in the following areas that can create a more non-binary appearance:
In addition, when thinking about non-binary body contouring, special attention must be paid to the buttocks region. In the image below, we see the body of a person who underwent estrogenic puberty on the left, and an androgenic puberty on the right.
If a non-binary person desires a more feminine body shape, we can do fat grafting and liposuction to create more of the “S-curve” shape that we see on the left. Conversely, if the patient desires a more masculine body shape, we can work to create a more boxy body silhouette that looks more like the image on the right. Because the skeletal structures are limiting to this procedure, when doing non-binary gender-affirming body contouring, we work with every individual to design a plan that works for them. We also take into account the extent to which the patient’s final gender form will be expressed, meaning we will discuss the ideals and expectations of non-binary body contouring at length.
Overall, when thinking about non-binary body contouring, our goal is to work towards eliminating characteristics that are overly masculine or overly feminine, depending on the goals of the patient.