Nonbinary  Surgery Overview

This content covers the fundamentals of gender identity and the surgical techniques that GCC surgeons have used with nonbinary (also known as gender-expansive, among many other expansive terms which are used) patients. This broad introduction will hopefully answer some important questions prior to getting into the specifics of each procedure type. For further information, you may view this hour-long lecture on non-binary identities and surgeries from the 2019 Philadelphia Trans Wellness Conference. Do proceed if you are 18 years old or older, and comfortable with such materials.

What Does Nonbinary  Mean?  

In order to understand what it means for some people to be nonbinary, it’s important to start with basic definitions and distinguishing factors between assigned sex and gender identity:  

  • Assigned Sex: When an infant is born, the physician will determine the infant ‘male,’ ‘female,’ or intersex (usually based on an examination of genitals, chromosomal features, and internal organs). Non-intersex babies are then referred to as “assigned male at birth” (AMAB) or “assigned female at birth” (AFAB) to more accurately explain that it was the doctor(s) who assigned the sex of the baby at birth
  • Gender Identity: Gender is not the same as assigned sex. Gender identity is an introspective experience and way of naming the gender one identifies with. There are many gender identities, including male/man, female/woman, non-binary, genderqueer, agender, etc. 
  • Cisgender:  You identify with the sex you were assigned at birth 
  • Transgender: You don’t identify with the sex you were assigned at birth, often referred to as an “umbrella” term for all gender identities other than cisgender
  • Gender Binary: This is essentially a societal system that splits people into one of two set of gender roles, gender identities, and physical attributes as either ‘male’ or ‘female’ 
  • Nonbinary : Nonbinary  gender identity is any gender identity that does not fall exclusively within the binary of male or female 

It is important to note that nonbinary  genders are not new concepts and have been recognized throughout the world for a very long time. Nonbinary people use varied pronouns, so it’s always best to ask what someone’s pronouns are when meeting someone  for the first time.

Some nonbinary people pursue medical interventions like going on hormones or getting surgery. Others will bind or tuck, cut or change their hairstyle, use different pronouns, or go by a different name. Some people will do a combination of all of these, or none of them at all. Since gender is a spectrum, someone who identifies as non-binary, genderqueer, agender, etc. may express their gender in neutral, masculine, or feminine ways, or some combination of all or none of these expressions. Despite current standards of care, there is flexibility in one’s medical alignment, which is what we hope to shed light on and affirm.

What does a non-binary surgical result look like? 

There’s not a simple  answer to this question; what we can provide are examples of all available surgical options. This way, the patient can make an informed decision on what surgical options may fit their needs. Whatever body a nonbinary person or any other person has is a body that is nonbinary/male/female/etc. There is no one “nonbinary” surgical outcome, and it is the same with any other gender. 

With over 2,500 top surgeries completed as of December 2021, our surgeons have a great deal of perspective on the variance of body types and the different outcomes patients may desire.  

It can get a bit confusing to think about all the different components of a top surgery result, including the parts that  can be modified and what it means to have a particular result look more masculine or more gender-neutral. So, the best way of discussing gender neutral results is to start with what might be considered the ‘ideal binary male’ top surgery result. From there we can discuss its binary features and then how those features could be modified to an individual’s preference to express a more non-binary appearance.  

Incisions and Chest Contours, as well as content on Nipple and Areola Options are great starting places to begin learning more about top surgery.