I realized I was genderqueer during quarantine. Or, at least, that’s the easy story to tell. It all started with the option to put pronouns on the bottom left of our screens. Broadcasting “she/her” didn’t feel right, and I pondered aloud to my spouse: “Could I be a they on Zoom?”

In reality, my gender journey has stretched across a lifetime. But, as an Xennial, there was no language for my experience as I was growing up. It was only recently, when younger generations created language that included the term “non-binary”, that I felt language accurately reflected my gender.

Prior to that, I strongly ascribed to a traditional “feminine” presentation, bleaching my hair blonde and flat ironing it straight. I was frequently told I was beautiful, and, indeed, being perceived as femme was flattering. In truth, I danced awkwardly with the concept of femininity, fumbling to fit into a category I believed should feel natural but squeezed me like a too-tight shoe.

As soon as I hit puberty and started developing breasts, they became a burden. They felt heavy and ill-placed on my body, as if they should belong to somebody else. Dysphoria haunted me across emerging adulthood as I tried to embrace my curves and ample cleavage but continued to experience a deep discomfort whenever I stood topless in front of a mirror or struggled to pull a button-up shirt across my chest. How could I move through the world feeling so ill-at-home in my skin? I was something other than who my body announced me to be. It was an ineffable, isolating experience.

Desperate for gender freedom (though not consciously knowing this was what I craved), at the end of high school, I shaved my head and collected tattoos and piercings to find myself. Over the next several decades, I changed my “look” multiple times a year, trying on multiple identity presentations and hoping one would fit. But my true coming out was in 2020, when I tentatively typed “they/them” beneath my name.

One of my trans doctoral students took notice of my Zoom pronouns and, when we returned to in-person instruction, stopped me in the hallway. “Are you going to join my trans army and help me take over the world?” they asked.

I was startled. Though I had announced my pronouns a few months earlier, I had yet to openly talk about being genderqueer. “Y-yeah,” I stammered. “Sure”.

They flashed me an all-knowing smile and said, “welcome,” and I flushed with gratitude at the affirmation.

Beyond my husband and therapist, they were the first person to acknowledge my queerness face-to-face. This student, now a dear friend, became a safe harbor as I started to openly navigate my genderqueer identity. I mustered the courage to ask them about top surgery resources when I realized it was something I desperately needed. As I engaged in the laborious and high-stakes process of seeking a supportive letter from my therapist and collecting the necessary information needed for insurance coverage, they comforted and validated me when it all felt overwhelming. And they introduced me to my plastic surgeon.

A looming figure with kind eyes, he is as compassionate as he is skilled, and his team is supportive and welcoming. They work intimately with the queer community and have a reputation for compassionate care. As I nervously exposed my chest at my first office visit, my surgeon treated me like a human who deserved happiness with their body, an expert in myself. The first time I affirmed my non-binary identity in that setting and heard myself say it aloud to medical providers was the first time I realized I truly was worthy of a body that I loved, that I wouldn’t conceal or shy away from, that didn’t make me wish I wasn’t myself.

Almost exactly a year ago to the day I type this essay, at age 42, I got top surgery. The initial aftermath, as most who have experienced this can agree, was uncomfortable: I struggled with itchiness from the compression vest and, as a stomach sleeper, railed bitterly against my wedge pillow. Professionally, I am an academic who runs a doctoral program, so I was back in class less than two weeks later and had to be mindful of my “t-rex arms” when trying to write notes on the white board. But at every follow-up surgery appointment, I glimpsed my beautiful, flat chest and felt euphoric. It was like a rebirth. About six weeks after the surgery, I was formally discharged.

Then, trouble began.

In October, two months after my top surgery, I started noticing soft, squishy, and tender lumps developing in my chest. One was especially large and concerning. What’s more, my incision began to reopen in multiple spots where the sutures had dissolved. Concerned, I returned to the plastic surgeon’s office. They referred me for an ultrasound, as it was too early in my recovery journey for a mammogram. The radiologist found one lump to be particularly suspicious for cancer and sent me for a biopsy, which was deeply anxiety-provoking as well as uncomfortable. Those days of waiting on the results were existential torture but, thankfully, the lump was benign.

The following week, another large lump formed, and I had yet another ultrasound, which the radiologist read to be benign as well. Unsure of what was happening beneath my skin, the plastic surgeon ordered a breast MRI. After some contentious battles with insurance to get the MRI approved (gotta love U.S. healthcare), the February scan revealed more cysts that didn’t look like cancer, but all the same were causing me immense discomfort. The wounds along my incision lines continued to form scabs that would repeatedly reopen and ooze, sometimes unexpectedly soiling my shirts in the middle of the day, as well as thickening my scar line. I was in pain, confused, and worried. I began seeing my plastic surgery team bi-weekly for wound checks and follow-up. I wasn’t healing.

I soldiered on, never missing a day or meeting at work nor time with my four children, but I was exhausted and constantly anxious. I was hypervigilant about my chest and wounds, often changing my shirt mid-day or waking up in the middle of the night covered in fluid. I constantly checked for new lumps, and I became a regular at the plastic surgeon’s office where they all expressed hope that I would one day “graduate.”

People who knew about my top surgery were eager to ask how great I felt, but the answer was complicated, and I avoided the question. By April, we made the decision for a surgical revision. The surgeon would repair my thick, raised bilateral scars along the incision line and remove all the cysts, hopefully putting an end to the issue. He suspected there were some areas of necrotic tissue that, despite their best efforts during the first surgery, lost blood supply. Removing the cysts should stop them from coming back, and I could finally heal.

After my second surgery, I felt great. I was attached to a special portable wound vacuum called a PICO for a week before my chest was revealed once more. My new incisions looked beautiful and clean, and the wounds were gone. I no longer had multiple cysts. Once again, I was elated at the simple, quiet beauty of a flat chest. It was what I had always wanted. Recovery was faster this time. I was hopeful that now I could truly enjoy the results.

Two months later, I grew a new large, painful cyst and several small ones, and the sutured area of my incision once again began to reopen and thicken the scar line. The bi-weekly plastic surgery appointments began again. I trudged forward, and my team continued to seek explanations for why this was happening and what could be done. After being put on a rigorous protocol of antibiotics that did nothing except make me physically sick and mentally tired, I was booked for a third surgery, which will happen in a few days, just after the one-year anniversary of my first top surgery.

My top surgery was not what I expected. It created chronic issues I have spent a year navigating. This includes negotiation with insurance, specialty care visits, and constant preoccupation with my health. I cannot wear light-colored shirts for risk of my wounds staining them. I am frequently in pain, and there has yet to be an explanation for my complications. Like many with chronic health concerns, it’s isolating, because very few people are walking the same path. It’s also incredibly difficult to talk about with others, because my top surgery was the culmination of a lifetime of gender dysphoria. None of my feelings about this are a quick conversation. Plus, my chest isn’t exactly small talk, and people expect a quick “I feel great!” answer when they inquire.

When I do discuss it honestly, the first question I invariably get is: “Do you regret it?”

It may surprise you, but the answer is always an emphatic NO.

I don’t regret it, and I would do it all over again.

The truth is, cysts and wounds and all, I am in love with my chest now more than ever. When I look in the mirror, I don’t see lumps or flaws. I see a body that fits me, that holds me, that reflects who I truly am. My chest, no longer pronounced, does not tell an entire story or create assumptions about my gender. Rather, my entire body, my entire self, works together to reveal the real me, in my entirety. Clothes fit in such a way that I love getting dressed now. I no longer struggle with bras and underboob sweat. And top surgery complexities are welcomed here. They are a meandering map of a complicated journey, because what transitions in life are linear?

I don’t feel betrayed by my body, nor do I think it has done anything wrong. Together, my body and I are growing and changing. We are emerging into a new phase of life. I am evolving, and the medical focus on my chest has caused me to think about it more, to nurture it, and nurture myself in the process. Unexpectedly, my complications have created a deeper intimacy with my new, queer body, and with each day that passes, I grow further into myself, into a body that for several decades did not feel like home. I am now taking the time to love myself in ways I neglected before. My medical issues have only strengthened my own understanding of how meaningful it is to have the chest I want and what a privilege it is to be authentically me. While I rejected my chest before the surgery, now I embrace it. I care for it with love and devotion. I want it to get better, because it is beautiful, and I deserve this happiness.

This does not mean I don’t get frustrated. I hate talking about my issues with people who haven’t walked the top surgery path and assume I am full of regrets. I’m exhausted by insurance claims and co-pays. I’m tired of tests, surgeries, and recovery. And I don’t see experiences like this reflected in the media. Most public top surgery stories reflect a one-and-done experience where healing takes some time, but ultimately the scars fade. We rarely hear about how healing can be an iterative and potentially complicated process. I’ve never read about an experience like mine, where there is a fragile dichotomy between the process of the journey itself, which is complicated, and the content of the same journey, which involves beauty and joy. Meanwhile, on the other side of things, transphobic narratives try to frame gender affirming surgeries as regrettable, risky choices in ways that intentionally fearmonger and confuse.

I have always been a writer and processed difficult experiences through translating my thoughts onto a page. Over the past year, I have avoided sharing my story for fear of unsolicited medical advice or its use as a cautionary tale that transphobes might misappropriate it to reinforce a false message that top surgery will only cause regrets. But the desire to share and create community as I heal is stronger. I wanted — needed — to write about the complexity of this journey, to share that things can go wrong, and you can still feel utterly whole.

I hope the next surgery is successful and that one day soon I can announce myself as fully healed. I hope that my story creates a space for others whose top surgery experiences haven’t gone as planned. But until then, I will continue loving myself and my beautiful body in all its flaws and complexities, because it is real and whole and entirely mine. And if you’ve gone through something similar, I hope you will, too.

This piece is part of UNDER COVER, an Autostraddle editorial series releasing in conjunction with For Them’s underwear drop.

Before you go! Autostraddle runs on the reader support of our AF+ Members. If this article meant something to you today — if it informed you or made you smile or feel seen, will you consider joining AF and supporting the people who make this queer media site possible?

Join AF+!