In the United States, the cost of having top surgery can range anywhere from $3,500 to $9,000, and getting health insurance companies to cover those costs is becoming increasingly difficult. Still, despite the difficulties, 33 percent of trans people report they've had some form of gender affirmation surgery.
Anyone can have top surgery (which is usually a subtotal mastectomy), but the procedure is commonly associated with trans men who were assigned female at birth and who want to undergo "deboobulation." Like many other surgeries, top surgery results in scarring. Unlike other surgeries, though, top surgery results in scars that operate like a neon sign on the side of a dusty highway at twilight. "HEY," they say. "I'M A TRANS PERSON." Even in the most benign situations, where someone genuinely doesn't know what the scars are from, the inevitable questions when a post-op person goes shirtless in the world can be awkward and uncomfortable. Like, "What happened to you?"
It's simply not possible or safe for some people — trans men, women, and nonbinary alike — to reveal they're transgender due to the overwhelming bigotry trans people face in virtually every sector of public life. And for those folks, there are tons of top surgery scar treatment options, ranging from herbal salves to plastic surgery that can reduce the severity of scars.
For other trans folks, though, showing off their scars is not only possible, it can be empowering. Here's what five trans men who underwent surgery have to say about their scars — and why they're not ashamed to have them.
1. Emmett Scout
"I like my scars!" Scout tells Bustle. "I may eventually cover them up with a big tattoo, but not because I particularly want to hide them — just because it would be a way of saying 'this is my body, and I'll do whatever the hell I want with it,' which is also how I feel about the scars themselves."
Scout says the one downside is that his scars make it harder to pass as a cisgender man. "But that's not really an issue with my scars so much as with society in general," he says. "In isolation, I feel like they're a testament to what I've been able to accomplish in my transition, so I have fond feelings for them."
2. Ren Prince
"After my surgery, I used a gel to reduce scarring for a little bit at the surgeon's recommendation," Prince says. "However, because of the incision length and some trouble with stitches, the scarring still ended up being pretty intense, and wraps around half my chest.
"At first, it bothered me because of my confidence issues. But it's been almost two years since my surgery, and now I'm at peace with them. Scars tell stories, and my transition is a hell of a tale. Not to mention big scars have a way of making you look pretty badass!"
3. Devin Harnois
After his surgery, he let his scars do their thing, Harnois says. "They healed pretty well, leaving only a thin white line. I consider them a mark of...maybe not quite pride, but a symbol of how I'm shaping myself to be who I truly am."
Harnois's surgeon did open a discussion about "touch-up work" to reduce the scars. "But he also said my results were really good," Harnois explains. "Before surgery I'd thought about tattoos or something, but now I don't feel the need to. Top surgery was the most expensive gift I ever bought myself (all out of pocket), but it was so worth it. Having a flat chest is a huge relief. I never have to worry about bras or binders or how certain styles of shirts will make me look. I can look in a mirror and see a body that makes me happy."
4. Lex Townsend
Townsend had his surgery four years ago, and because of the type of surgery he chose to receive, his scars are much more obvious than with other top surgery options. "I had pedicle surgery, so my scars go across my chest, rather than under the pec, and the nipple sits on top. I chose the relatively more noticeable scars as a trade-off to retain more nipple sensation," he explains.
He used surgeon-recommended silicone scar cream and pore tape as part of his recovery, he says, which he was careful to do, but didn't seek any other post-op treatments.
Now, he doesn't want to get rid of his scars, which he describes as "pronounced in color when I'm really hot or cold, but are pretty much covered by more recently developed chest hair. The pedicle has been bunched up [in my chest] and there are odd gaps. So my chest feels a bit untypical to touch, but looks flat and smooth with the slight scar still visible across."
5. Nate Quinn
Quinn says he hasn't changed his scars in any way. "They have stretched a bit because that's just how my body heals, but I'm very happy to have them and I'm so proud when I get to show off my chest — scars and all," he tells Bustle. "I'm just thrilled to have the chest I always dreamed of having."
Unlike Harnois, Quinn has never had anyone encourage him to have his scars changed. "[I]f anyone ever does I would never even consider it because although my scars are very obvious that's exactly what I wanted. I'm proud to be a trans man and that equates to me being proud of the scars that have come with this journey for me.
"Top surgery for me," he says, "is freedom."
There are plenty of trans folks who don't feel the need to undergo any form of gender affirmation surgery, but for those who do want surgery, finally going under the knife after jumping through the many financial, insurance-related, and often psychiatric hoops can be one of the happiest moments of their lives. And for these trans guys, the scars they emerged from surgery with are testaments to the steps they've taken to bring their bodies closer to who they are.