Nonbinary/Gender nonconforming breast reduction journey: WITH TIPS IF YOU’RE SOMEONE DECIDING BETWEEN REDUCTION AND TOP SURGERY
Writing this for the lovely communities of top surgery and reduction (to which I spent hundreds of hours over the last six months), and for the gender queer people who are still early on in this journey.
On June 11th of 2026, I had 423 grams removed from my right breast and 511 grams removed from my left. I’ve known for little over a decade now that I would get some kind of chest surgery, but I spent years agonizing over what kind of surgery that would be (full top, or some kind of reduction).
I’ve hated my chest since it started growing. It has affected every part of my life. I would think about my chest with such soul crushing disgust every single day from being a tween to age 26 because it ruined every picture I was in, every outfit I would wear (even with a binder), made me feel ugly, caused me pain, and made physical intimacy unfathomable.
My chest wasn’t ugly. In fact, objectively it was very beautiful. I had large, full, round, perky breasts that many women were envious of, but they never felt like they were mine. They didn’t feel like they should belong to me. Sometimes I could recognize myself as sexy (as someone who is attracted to women) but most of the time that didn’t matter because of how disconnected I felt from my own body.
I often went back and forth between top surgery and a reduction. I was so confused for so long it paralyzed me from moving forward until six months ago, when I got spine X-rays, and I realized how damaged my body was physically from all the years of slouching. Something had to give.
I started researching like crazy. I would come home from work every day and watch tik tok and YouTube testimonials, read this subreddit and others like it for hours, and then I would go to bed and do it all over again. It was brutal, facing it head on and not allowing myself to hide from it anymore. Here is advice I have for anyone walking down this path and struggling with similar decision:
TIPS THAT HELPED ME MAKE A DECISION
Figure out and understand bra sizing
This is important because something like 80% of women wear the wrong size bra. If you use https://www.abrathatfits.org/calculator you can find your true size. Knowing your size is important because it firmly grounds you in your reality. I measured myself to find out I was a 34G/H (US). For me personally, realizing my chest was large enough to make finding a well fitted bra (in stores) next to impossible contributed to my decision making. I realized that the majority of my dysphoria came from having a chest I could not ignore (due to sensory issues and ill fitting bras), and that I could never hide. I thought about how I would feel if my chest was easily concealed by clothes and if I couldn’t feel it at all times. I found that I didn’t hate the idea of a reduction if I thought like this.
Knowing your size is also important because it allows you to take your band size and research. Find as many pictures of people with YOUR band size and ideal chest size as possible if you’re thinking about a reduction. This will make communicating to your surgeon so much easier as cup sizes are never an accurate means of measurement.
Even if cup sizes matters less when communicating to a surgeon it’s still important to understand how bra sizing works as it can help break the misinformation that can feed dysphoria such as “A cup is small and D-DD is massive.” This is simply untrue. I’m measuring about a 34DD 3 weeks post op, and all this means is my underbust is 34 inches and the fullest part of my bust is currently 39 inches. The five inch difference sounds more significant than it is. I can wear medium flimsy bralettes from target now, and I barely read like I have boobs at all. It’s all so dependent on your frame. Understand the numbers and letters for yourself, but don’t cling to them like a lifeline.
Think about how important your nipples are to you
This is an important step regardless of your choice because chances are, if you decide on top surgery or a very aggressive reduction, your going to need a FNG (free nipple graft) which is where your surgeon physically removes your areola complex with the nipple, and then sews it back on at the end of the surgery like a skin graft. It is important to know this because after a FNG you never regain erotic sensation (and sometimes you never regain any sensation at all), and you can never breastfeed again. Your areola complex will also look very different from your original after you’ve healed from a FNG. I suggest you look at many pictures and weigh the importance of your nipples as they are.
They CAN keep your nipples attached with a breast reduction, and most of the time you can keep sensation and have a shot at breast feeding, but if you do that, you sacrifice how much tissue can be taken, as enough must remain to keep the attached nipple alive. (Most results I’ve seen that go as small as possible are half to 1/3 of the original size, myself included).
There is also, of course, the no nipple option. If you forgo nipples entirely your surgeon can remove as much tissue as you would like, and your recovery is generally smoother than that of healing the nipple graft. This is the option I would’ve chosen if I would’ve had top surgery, as the idea of detaching a piece me entirely and sewing it back on grossed me out. I also did not love the idea of going through the healing a graft only to have ornamental nipples that I might not like the look of when it was all said and done. Plus, I have no interest in passing as a cis man.
Think about the clothes you want to wear post op and find people online who have your body type and style
This is something that helped me immensely. Tik Tok is what I recommend as it allows you to find a vast variety of people walking, talking, wearing different clothes, and living authentically. I watched a lot of fashion vlogs and GRWM videos from trans people. I knew I still wanted to dress fem, so I found some good accounts of people with full top surgery dressing as feminine as possible to help aid me in my decision. I never could quite apply the way they looked to my own body. I didn’t want boobs, and I liked the way full flat looked in some outfits, but I could never fully see myself in the way they looked, that helped steer me towards reduction.
It’s harder to find representation in breast reduction Tik Tok videos, as a lot are made by cis women, but you can find radical reductions if you really look. But don’t just limit yourself to people who have had surgery. Look at small chested queer people online dressing how you wanna dress and visualize yourself instead.
This tip in general involves a lot of staring at other people’s boobs and a lot of thinking about boobs and your own body. It’s hard. It’s exhausting. It took me months of doing this to even kind of have an idea of what I wanted. Be kind to yourself and take all the time you need.
Read many surgeon reviews
Look at surgeons who do both top surgeries and breast reductions.
Look at just top surgery surgeons.
Look at just breast reductions surgeons.
Even if you are wavering in your decision it’s not a bad idea to get a sense of who you would like to go to for either procedure. Look in your area. I had 2 surgeons I was considering for top surgery and about 3 I was considering for a reduction. I found all of the reviews on Reddit, though occasionally Facebook or the surgeons own website proved hopeful as well.
Don’t waste your time with consults if you haven’t made up your mind. They won’t help you make a decision.
It is also important to be aware that many surgeons require you to get a detailed letter of recommendation from a psychiatrist or psychologist if you want to have even a consult for top surgery. This proved somewhat disheartening to me as I did not have a current therapist, and ones I went to wanted to have many sessions before even considering providing me this letter (you do not need a letter for a reduction consult).
Talk to someone neutral who won’t care, or judge you for being uncertain
This is perhaps the hardest thing on this list. It is incredibly alienating a process to be deciding between two very different surgeries. If you tell the supportive people in your life you want top surgery, and they support you, and you go back on your word, you are in danger of both cis and queer people judging you for “not being trans enough”. If you tell people you’re getting a reduction (a more widely accepted procedure that many cis women get) and then you change your mind, you may face having to endure many exhausting conversations to affirm your identity as you go from an accepted cis surgery to less accepted queer one.
Use the internet or a therapist if there is no one in your life you trust to be completely neutral. I met with several therapists who knew nothing about me so I could discuss this and only this. I would recommend this strategy if you don’t think you’re ready to confide in your established therapist, or if you would like multiple people to talk to.
Reddit is a wonderful place. My DMs are open to any wanting to discuss their journey.
Make a decision and stand by it!
There comes a certain point where you simply must make a decision. I was in an intense state of going back and forth, whilst simultaneously doing about 3 hours a day of research, for about 4 months straight before I said fuck it and booked a reduction consult. I knew I needed relief, and I also knew that either one of these surgeries would make my quality of life significantly better than it was. I chose reduction in the end because I wanted to see how I would feel with smaller breasts first before committing to top. I might still get top surgery one day, but so far life is very different with small breasts, and I find that, for the first time since I was very young, I don’t entirely hate what I see in the mirror.
If you’ve done everything in this list, have labored, talked, researched, and sat with this decision for months, reduction might be the way to go simply because, like I said above, you have the option to get top later. And YOU, dear reader, deserve relief. Don’t push this decision aside and ignore for years and years when it gets too hard (like I did), put in the work, face the discomfort, and I promise one day you’ll arrive exactly where you’re meant to be.
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