Having top surgery as a non-binary person was how I fell in love with myself for the first time
It’s the little things that I notice. Sometimes, the feeling of a T-shirt pulling across my bare shoulder blades. A glimpse of my side-profile in a shop window. Walking around in just a pair of swimming trunks.
I had top surgery five months ago, with Mr Christopher Inglefield at The London Transgender Clinic, and these little things bring me moments of happiness each day. No matter how tired I am, how worn down by the pandemic and stressed by reporting on structural transphobia, the feeling of my flat chest and the loud new closeness of my heartbeat brings me a deep peace.
There are big things, too: the absence of dysphoria, the unfettered joy in my nakedness, the slow unlearning of hunched shoulders, the growing confidence in myself. This is my first summer not wearing a binder in several years and, damp English weather aside, being able to wear what I want without first considering the logistics of binding for the day saves a great deal of time and mental anguish. Being able to breathe properly when it’s hot is pretty good, too.
My road to top surgery felt long. It took me almost the entirety of my twenties to work things out – that I was trans, that I was experiencing gender dysphoria, that there were gender-affirming surgeries which would alleviate this – and by the time I had, I’d also realised that the real waiting had only just begun.
I had been on the waiting list for an appointment at an NHS gender clinic for over a year, with the prospect of several more years still to go before I could actually get any help or treatment, when I started considering going private.
Top surgery: Which surgeon to pick?
So, last summer, I started researching surgeons who do top surgery privately. But there were so many different options that I was overwhelmed, especially as looking at before and after pictures made my dysphoria worse.
Picking a surgeon was a formidable task. Different surgeons have different costs, assessment processes, techniques, results, recovery times, waiting lists, and rules about when you can wash, exercise and, vitally, be topless in the sun.
Some clinics need you to already have a gender dysphoria diagnosis, some do this themselves; some require you to be taking testosterone, some don’t. At some clinics, non-binary people like me might have to pretend to be trans men to be considered for top surgery.
Finally, I decided to just book an initial consultation and see how I felt. I first met Mr Inglefield in January over Zoom. He rattled assuredly through his process for top surgery in one sweet half-hour burst of information, ending months of confusion and doubt. My questions for him were, essentially, “Can you do it, and will you do it?” The answer was a firm yes.
Mr Inglefield said his priorities were how my new chest would look and feel – and his explanation of the surgery and aftercare was simple, affirming and non-judgmental. He didn’t interrogate me as I had feared, just laid out what was possible with a minimum of fuss and asked straightforward questions about my health, gender-related medical history and support network. After our consultation, I paid a deposit and was added to his waiting list.
The London Transgender Clinic
Due to a cancellation, I had top surgery less than a month later, in February 2021 – with just eight days notice of my surgery date. I work somewhere with an HR transition policy that gives trans employees paid time off for surgery recovery and specifically advises giving trans workers flexibility if surgery dates come up at short notice – something all trans people should have access to, though few do. I am also lucky that my job reporting on trans healthcare could include documenting my top surgery, in return for a discount with The London Transgender Clinic.
It could have been stressful, having such major surgery at short notice, but because the team at The London Transgender Clinic are helpful, knowledgeable and reassuring, I was excited and confident.
I met Mr Inglefield for the first time in real life right before surgery, sat alone in a gown in a private room at a Harley Street hospital. He drew lines on my chest with a purple marker, went over what I could expect before and after surgery, and gave me a comforting squeeze. When I woke up, he told me it had gone well, and checked I was taking deep breaths despite the pain.
Healing from top surgery will look very different for each person. The first weeks of my recovery are a haze.
My chest was bandaged up, and a foam pad lay across it under a tight compression vest. For the first five days, I had drains in my chest to help bring the swelling down, which were painful and tricky to walk around with and meant I couldn’t wash. But the painkillers were good, and I dozed propped up by pillows while me and my sibling unironically watched the entire Harry Potter movie series back-to-back.
After the drains were taken out, so gently and carefully by Thamara, the LTC nurse, I was able to move around more independently. Weeks two and three saw me mostly sleeping, with the energy for one or two tasks per day – making a meal, or having a shower. I had to be careful not to lift my arms or press on them, which made getting in and out of bed slow and hard. Because of the lockdown restrictions, I couldn’t have friends or family into my flat to help me, so life became slow as I managed my recovery solo.
Once a day, I unzipped the compression vest so I could shower. Under layers of thick bandages was my new chest, but I couldn’t see it. After 10 days I went back to The London Transgender Clinic and Thamara took off all of the bandages, hovering kindly in the background as I cried looking at myself in a mirror for the first time.
Falling in love with myself after top surgery
For the next few weeks, the mirror became my new best friend.
I’ve avoided seeing myself in mirrors for most of my life – just like I’ve been uncomfortable having my photo taken and going swimming with other people. But now my day included a new routine where, after a few hours resting and drinking tea in bed, I’d slowly take off the compression binder and stare at my body in a mirror. I took hundreds of photos of myself. I left a friend a long, rambling voice note that ended with me saying: “I feel like I’m falling in love with myself for the first time.”
The milestones passed by, big and small, and the love I felt for myself and my body grew with each one. Walking all the way around the park for the first time post-op. The day when, finally, I could stop wearing the compression binder and just had a layer of micropore tape over my scars and nipples. The first time I stood in a shower with just the tape on my chest and looked down at my body and felt whole. The first time, and all the times after, that I saw my chest without tape or bandages. The first time I touched one of my numb new nipples.
Trying to explain this feeling led me to clichés: it felt like the first time I fell in love, that intoxicating feeling of falling off a cliff wrapped up in someone else. It felt like the sense of belonging when walking home with close friends after a really good night out, meandering through London’s streets in the early hours picking up booze for the afters. Nothing really came close to describing the joy I felt in those first heady months after top surgery.
At my three-month post-op appointment, Mr Inglefield said that healing was going well but that I should keep wearing the micropore tape for another six weeks to support the scars. At this point, I was feeling frustrated with how slow my recovery was going – other people’s seemed much faster – and uneasy about the shape and length of my scars and the swelling that remained in my armpits. Mr Inglefield was kind and direct. He reassured me that it was going to look great and that I just needed a bit more patience.
Five months after top surgery
Mr Inglefield was right, of course. The time that I spent wearing the tape has faded into a small pocket of the past and my scars look great – they are smooth and even, gradually fading day by day, helped by the Bio-Oil that I’m rubbing into them morning and night. The swelling in my armpits has almost gone.
And the waves of gender euphoria keep coming. Sometimes it’s a big thing, like the first time I was naked with another person and realised how free I am now. Sometimes it’s those little things, like the curve of my back uninterrupted by a binder or sports bra or layers of clothing worn to flatten my chest. No matter how exhausted I am, running a hand over my chest brings me a quiet moment of joy.
It took a long time to get here, but now that I’ve made it, what’s most magical is not the top surgery itself but the life that is opening up in front of me. It feels like my future has been unlocked; as if I can actively live my life in a way that was unimaginable before.
Getting top surgery with The London Transgender Clinic was one of the best decisions I’ve ever made. It has made my life better – in big ways and small.
And while top surgery is just one chapter of my story, just one part of me, it’s also magic, my new chest. It’s beautiful.