Gender Confirmation Surgery
I’m so excited to finally be on the wait lists for two pivotal gender confirmation surgery appointments.
I’m Getting Boobies!!!
My first draft of this article was pretty clinical and to-the-point, and when I sent it to my wife she said…
This is fine, but what about the part where you’ve been giddy and jumping up and down sending me GIFs about boobies all week?
What about the part where you were bouncing happily in your seat in the doctor’s office when they told you you’re finally approved and scheduled?
How about how you sometimes send me video selfies of yourself just happily screaming?
Bethany (paraphrased)
And she’s right! This is a joyous moment. I don’t have as much practice writing about uncomplicated joy as I do about deep uncomfortable insights plumbed from the depths of my soul. But it’s just as true now…
I’m the happiest I’ve ever been.
The truly dire and horrifying events of 2025 forced me to buckle down and get my stuff in order. While so much of the big wide world explodes, some truly magical things have come about in my small world.
- I have lots of plans for if and when bad things happen. Documents are filed, arrangements are made, support networks are prepped. I’ve officially done — or set in motion — everything within my means to protect myself and my loved ones.
- Leaving social media drastically improved my life. I’ve connected with people in real life so much better and more frequently since. My daily mood is better. I feel more in touch with my friends and neighbors than ever.
- I’ve met new people over the last several months who’ve quickly become important parts of my life, and I’m feeling appreciated and cared for in ways and degrees I’ve never previously experienced.
- My transition progress has really helped me have more social energy to create and attend all these social events. It’s amazing how much not having to perform/mask turned me from an intro/ambivert into a pretty solid extrovert.
- Looking in the mirror and seeing someone I think is beautiful each morning, even when my hair is all jacked up and I’m covered in dog fur has been life changing.
I’m even excited when people ask me how I’m doing so I can gush about everything.
Yes, the horrors absolutely still persist, but I’m not letting them stop me from living in the present and building a life I want to grow old in.
Radical Honesty
In addition to breaking my tech addictions, I credit this joyous moment to my continued work gradually unmasking and dropping performative aspects of my life. This began during the pandemic, really took root when I moved into my home, and I honestly lost track of it since. Radical honesty was neatly rolled into my life and became the norm.
I recently lost a friend who’d become increasingly abusive. Their spouse and I were discussing ways we can help them because it’s no longer productive for me to keep direct contact. I was giving the spouse advice about telling the truth about their feelings and self-advocating for the relationship they want with my former friend.
How do you deal with it when they don’t respond well to honesty?
My ex-friend’s spouse
The question made me think, when was the last time someone reacted badly to my radical honesty?, and I had to go back over 5 years. I recounted a story of when someone I deeply cared for reacted unenthusiastically to me sharing some feelings about my identity, and how in hindsight I’m really glad I got that clarity.
Even when “the worst possible thing” happened, I was still glad I was honest. It’s led me toward a life better-suited for my authentic self.
Confirming my gender presentation to the world is another act of radical honesty.
“Before” Photos
Most of what HRT is doing for me is internal, but the physical changes are incredible too. After nearly 2 years, I’ve noticed some remarkable positive changes to my appearance and how it makes me feel. Most of those changes are literally skin-deep and from the neck down. My bones and cartilage are still those of someone who developed for 40 years without HRT.
HRT has reshaped my body to be a little curvier. Shaving and lasering off my hair, shaping my eyebrows, and growing out my hair have really transformed my body in ways I love.
Each morning when I wake up and see myself in the mirror it doesn’t bring me down the way it did for 30 years. I no longer reflexively avert my eyes from my own reflection. I’m more comfortable taking selfies. I have more social energy for going out and spending time with friends. When people compliment me on my appearance I’m starting to believe them.
My 2017 Post-Weight Loss Body
At the time this was the happiest I’d been with my body since my car accident took me out of football, MMA, and other activities I enjoyed. While it was definitely a big improvement, I wasn’t as satisfied with my body as the people around me were. Part of me was disappointed; after all this pain and effort I still didn’t feel 100% happy in my skin.
I took this as a reason to work more on my mental and spiritual side. I meditated in pursuit of letting go of desire, to pull my actualized self closer to earth, reducing my distance from enlightenment. During this spiritual journey I reached several epiphanies including ones regarding my gender and orientation.
Flash forward to today, I’m 40 lbs. heavier than I was then. I feel much better in my body — comfortable in my moderate softness. I’m happy with my budding breasts and curvier butt. And — despite what concern trolls may want to assume about my health — my blood pressure is still excellent and my labs are all in the green.
External Validation
Looking back at old photos now, I feel uncomfortable remembering my facial and body hair. I definitely don’t miss it.
I’ve shaved or waxed my body hair since I first began growing it, but if whoever I was dating asked me not to, I’d stop. I did that a lot. I resigned my body isn’t for me; it was for my partner. I let them have input in how I presented the parts I didn’t like or care about.
I felt unconfident about my body hair and clothing because no matter what I did, I was uncomfortable.
- Either I remove all my body hair and like myself better, but people who noticed thought it was weird, -OR- I keep it, get positive feedback, but feel icky all the time.
- Men’s clothing is boring, confining, and often extremely uncomfortable for me, so I rarely found anything I actually enjoyed wearing. I may as well wear what my partner thought was cute or throw on whichever t-shirt was on top in my drawer.
I avoided looking at myself in mirrors for decades, telling myself “I’m just not my own type.” I didn’t think anything could realistically change my aversion. Seeing others look at themselves in mirrors, take selfies, and feeling themselves felt so foreign to me.
Fears
I feared I wasn’t loveable
if I didn’t play
a specific role
in the desires of
people I dated —
I’d be alone
if I did what I want.
I learned — far later in life than I’d prefer — being comfortable in my skin, clothes, and manner should never be compromised for the sake of others. I learned, as we all do over time, I wasn’t always right about who the right people were for me. And I eventually learned, while loving myself for the first time, how I don’t have to give up before I even shoot my shot to connect with people I place on pedestals. I am worthy of standing beside great people.
As I started working at it, I began to see small glimmers of happiness in the mirror. Over time, the happiness grew to be visible to others too. Once I hit my stride in confidently doing what I want with my expression, I got more romantic attention from the right people than ever.
Social Reactions
After I lost my weight I wrote a one year later post, but I left out a few things. At the time I didn’t think it was focused on what mattered, but these experiences were part of my weight loss story.
- People treated me better in ways I didn’t expect. While it was nice to feel heard and seen, it disappointed me how those people wouldn’t listen to me say the same exact things when I was fat. Especially at work, where my appearance shouldn’t have any bearing on my performance.
- As I expressed with the featured image from the one year later post, I felt tiny. I felt lighter and weaker than I wanted, but thought I’d get used to it. I did somewhat, but also felt better after gaining some weight back and hitting the 190’s.
- I missed my bigger chest. At the time, I thought I was grieving lost muscle mass. In recent years as I’ve enjoyed my breasts growing from HRT, I think those feelings may have meant more.
Much like my weight loss procedure, I don’t know how people will treat me after I get gender confirmation surgery, nor how it’ll feel, nor how I’ll react to those feelings. I’m nervous, but mostly excited to find out.
Dare I hope
if I pass more,
my public life will improve too?
So far, transition has made me feel excellent inside while being treated worse by strangers. I’m doing all this for me. I’m trying not to put much weight in external validation anymore, especially not from strangers, but it’d certainly be a nice bonus.
When are my Surgeries?
I’m getting top surgery in November, right before the Thanksgiving holiday weekend! 🎉
After I get my boobs, I need to wait at least 3 months before I can do Facial Feminization Surgery. I don’t know my official date for FFS yet. I just got put on the wait list and they tell me it’s estimated between 6-12 months but leaning towards 12. They’ll contact me 3 months before when it’s my turn to schedule it and when I get the date I’ll share more info — likely Spring or Summer 2026.
Part of me wondered if I was rushing things when I first started pursuing this path in 2023. After researching, consulting with doctors, and telling my story to dozens of strangers trying to get insurance approved my impostor syndrome has finally died and I know for certain I’m ready. The day can’t come soon enough.
An infinitesimally tiny part of me is grateful for all the speed bumps, delays, and check-ins Kaiser made me do to get me to 100% certainty. But I arrived a few months ago and still have a long wait left so I’d still prefer they toned it down a bit.
Politics, Healthcare, Insurance, and Money
Obviously, the political climate of our country is terrifying. My excitement and impatience to finally look the way I want sits with the anxiety of racing against the clock to beat the likely near future where insurance companies are either banned or disincentivized to provide or cover gender-affirming care.
While I would certainly pay out of pocket for all of this if I had to, saving tens of thousands of dollars on it would be ideal. Kaiser already has irrational logic for which procedures they do and don’t cover for Facial Feminization Surgery (“we cover your eyebrows and nose, but not your cheeks” and such), but it’s better to pay $11,000 than $25,000+.
This is an investment in myself that I know will make each day after easier and happier for me.
When I think about the way I view the expense of these procedures it’s close to what I felt about my student loans when I was a naive high school senior signing all these papers to invest in my future happiness and prosperity. Except this isn’t being hard sold to me by others. If anything, most people have tried quite rigorously to stop me.
What is Breast Augmentation Surgery?
This is a well-known procedure with low risk and short recovery time. I’ll leave the hospital after surgery without an overnight stay and be back to work in about a week or two.
I’m getting silicone implants over the muscle to get a size proportional to my wide shoulders. My surgeon is ordering three different (large) sizes and will decide which one fits best in the operating room.
I’m aiming for a natural look, aspirationally similar to a plus sized model:
I hope this is attainable for me, but I’ll at least get close. 😊 I’m so excited to go bra shopping, and for bikini season 2026!
What is Facial Feminization Surgery?
FFS edits the structure of the face to reduce features generally considered masculine in appearance and enhance features generally considered feminine. The following mini-documentaries follow two trans women during their experiences with Facial Feminization Surgery.
These are not posted by my surgeon, who’s well-respected and reviewed in the trans world, despite not having a bold social media presence.
My surgeon was given reference photos of myself as I aged in addition to photos of women in my family to use as reference. While I hope to feel drastic improvements, I’ll still look like me. A me shaped a bit more as if I developed as a woman. It’s the shared goal of both my surgeon and I.
What I’m Doing
When listed out, it’s a lot, but it’ll all be done in one session with very low risk and overlapping recovery time. My goal is to only do this once.
- Scalp Advancement to make my fivehead into a forehead and smooth my hairline a bit
- Frontal Cranioplasty with Orbital Rim Contouring to soften my brow and let my eyes be more prominent
- Browlift to visually balance my forehead
- Rhinoplasty to narrow my nose and reduce the hump slightly
- Fix my deviated septum while we’re in there
- Cheek Fat Augmentation to give me a little more of a heart shape with my jaw and chin
- Lip Lift to raise my upper lip slightly
- Lip Augmentation for some more volume
- Chin Contouring to soften the angle a little
- Neck Submentoplasty to reduce neck sag from my weight loss and to balance the chin work
What I’m Not Doing
I’m leaving my jawline alone. I don’t mind it and think it’ll still look nice with my other features. Lots of very attractive women have jaws like mine. (Also: reducing the surface area there could make my double-chin more prominent.)
I don’t have much of an Adam’s apple, so no need for a tracheal shave, which is great because I’m very protective of my vocal cords and don’t really want to mess with that part of my neck if I can help it. I’m also not doing any vocal chord surgery either.
I’m not doing hair implants to supplement my scalp advancement. There’s not a ton I can do to really take my M-shaped hairline and completely convert it to a smooth arc, but I can be satisfied with the improvement I’ll get from the scalp advancement.
About Facial Feminization Surgery
If you’re not too squeamish (Mom, don’t watch these next two videos), these videos of some of the procedures I’m undergoing show the actual surgeon’s perspective while doing the work.
The Patient Perspective
Much less graphic, but far more annoying are the vlogs of young influencer types who show their day-to-day experiences before and after the procedures. If you can bear the Gen Z influencer vibes, constant posing, and dramatization of everything, it’s still pretty illuminating.
I’m trying and failing to repress my resentment at how much more femme these girls are than me before they even do facial feminization surgery! It’s not like they don’t need/deserve it, but they have a far shorter road than me and they get to fully enjoy their lives for longer because they started transitioning earlier in life. The jealousy! 😭
A Call for Support 📣
As with any major surgery, I’m gonna need some help. If you’re interested let me know!
Leave a comment if you’re interested in reading about all the hoops I had to jump through for the last year to get here.
Pragmatic Support
I believe I already have pretty reliable Plans A and B for the must-haves, but if you’d like to volunteer to be a backup for any of them, I welcome it!
One-Time Tasks
- Driver to surgery (day 0)
- Visit/stay during hospital overnight (day 0)
- Driver from surgery, help from car to bed (day 1)
- Driver to my first post-op appointment (day 7 — FFS only)
- Driver to my second post-op appointment (day 28 — FFS only)
In-Home Assistance
For the in-home care stuff, it’d also be wonderful to relieve my primary caregivers for a few hours here and there so they can live their own lives a bit too.
| Task | Timeline (BA) | Timeline (FFS) | Notes |
|---|---|---|---|
| Help Getting In/Out of Bed | days 1-3 | days 1-3 | Walking to/from the bathroom mostly. |
| Meal Prep | days 1-3 | days 1-3 | Mostly heating/plating prepped meals. |
| Medication Reminders | days 1-3 | days 1-3 | Nudge me to take meds if I’m out of it. |
| Dog Walking | days 1-5 | days 1-5 | 2-3 walks daily around ~9am, ~5pm, ~10pm. |
| Let Visitors In/Out | days 1-5 | days 1-5 | |
| Wound Care | days 1-5 | days 1-14 | Help applying ointment or replacing bandages. May only be needed for the first few days. |
| Mail/Packages Pickup | n/a | days 1-14 | May not be needed. |
| Laundry, Groceries | n/a | days 3-5 | May not be needed. |
Emotional Support
Being stuck in bed and unable to work or go out sucks. Company can distract me and make the time go by more pleasantly.
| Activity | Timeline (BA) | Timeline (FFS) | Notes |
|---|---|---|---|
| Remote | days 1+ | days 2+ | Phone, Video Calls, Discord, etc. Depends on how well I can talk (energy, pain, etc.). |
| Very Low-key | days 1+ | days 2+ | In bed, watching movies/shows together. FFS: I may not be ready to talk much, my vision may be obstructed. |
| Low-key | days 3+ | days 5+ | Out of bed, talking normally. We can game and do some light walking, but I may need you to hold Rogue’s leash for me. |
| Chill | days 5+ | days 8+ | Basically a normal chill hangout. |
| Active | days 14+ | days 28+ | Resume physical activities like hiking, swimming, etc. |
I theorize these acts are the ones I’ll need the most. Boredom and isolation really suck for anyone, but I feel extra sensitive to them.
Maybe I’m more of a “quality time” love language person than I’ve previously realized?
Recovery Meals
It’d be lovely if you’d like to visit and enjoy meals together or drop something off to help!
- MealTrain for Breast Augmentation
- MealTrain for Facial Feminization Surgery (date TBD)
After I’m released from the hospital, I’ll have special dietary needs for a while.
| Diet | Timeline (BA) | Timeline (FFS) | Notes |
|---|---|---|---|
| Liquid Diet | n/a | days 1-7 | Soups, porridge, soft scrambled eggs, smoothies, yogurt, ice cream, popsicles, apple sauce |
| Soft Foods | days 1-3 | days 7+ | Soft pasta, tender meats, heartier soups, meatballs, well-cooked veggies, cheeses |
| Normal | days 3+ | days 10+ | My second week after FFS I’ll want to exercise my jaw muscles more, so I’ll be ready for chewier foods around then. |
| Alcohol | days 7+ | days 21+ | I may not want it for longer, but it’s generally okay after these times. |
Monetary Support
If you’d like to contribute monetarily, please go through (in order of preference) cash, Venmo, PayPal, MealTrain, or my GoFundMe page. I also have my Wish List page for random other ideas if you prefer to distract me with unrelated gifts. 😊
I doubt people who don’t know me personally read my blog, but if you’re an anonymous stranger on the internet and want to provide support, I welcome that as well. Feel free to share this post or my GoFundMe link (https://gofund.me/9ca49b30) with safe, supportive friends and communities.
Gratitude
I massively appreciate whatever help you can contribute. My community has really stepped up for me in the last few years, and I strive to be worthy of it. Thank you from the bottom of my heart.
Boobwarming
After I told my friends about my top surgery date, they excitedly started planning a party for after I recover enough to enjoy it, which is so wonderfully heart-warming, I can barely stand it! 😭
Right now they’re debating whether to call it a Boobwarming, a Boob Shower, or Happy New Boobs party. 😂 I don’t know how to register for one of those, but I’ll allegedly be getting bras and other boob-related gifts? Comment if you have any fun ideas for what to call it or how to celebrate!
Also: I’m not saying your support will get you a titty flash,
but it certainly wouldn’t hurt your chances. 😇
Frequently Asked Questions
I’ll add more here as I hear them.
Wouldn’t adding weight to your chest aggravate your chronic spinal injury?
I definitely took this into consideration. I carried more on my chest than the weight breast augmentation adds for the years I was heavier. My neck pain didn’t substantially decrease when I lost the weight. My knees were happier, but not my neck and upper back. (And even if it did, it’s still worth it for me.)
Why are you opting-in for these annoying parts of being a woman?
I know boobs can be annoying and get in the way of so many aspects of daily life. I’m now well aware how estrogen messes with our emotions and chemical balances. I want all of it! I love when my boobs hurt after I run down the stairs to get my deliveries. I love crying about mildly emotional topics. I even love my 10x more complicated skin maintenance routine. It’s so annoying and awesome, and I know it’ll run out of its novelty any day now, but I even look forward to that.
I’m also lucky I won’t have to deal with periods, perimenopause, and developing into womanhood with the male gaze constantly upon me. I at least get to dodge those parts.
A Quick Note on Privacy
While I’ve been pretty transparent about other surgeries I’ve done, this one may not be fully safe or comfortable for me to share. I don’t know how many updates I’ll be comfortable giving or what kind of photos or other media I’m going to share publicly, but I’m happy to speak or message privately with anyone who’s in my care team. 💖
That said, I’m very excited and my enthusiasm may win out and I’ll overshare like usual. 😁
