Top Surgery Was Expensive, Scary, Risky – And The Best Decision I’ve Ever Made

Every time I see my scars in the mirror, I remember I prioritised my happiness over others' discomfort. But for too many trans people, that’s not an option.

I’m one of those people of indefinable gender that right-wing newspapers warn you about. I’m trans and non-binary, which is basically to say I don’t identify with the gender I was raised as, and I don’t believe that gender only has two options.

I’ve felt this way all my life, but I wasn’t always equipped with the vocabulary to explain it. As pretentious as it may sound, I tend to live by the Sherlockian mantra of eliminating the impossible and taking whatever remains, however improbable, to be the truth. I can’t say I know why people like me exist, I just know they do. And I know they always have, and they always will.

That’s why, just over a year ago, I went through a gender-affirming procedure commonly called top surgery. More technically, I had a double mastectomy with nipple grafts to give my chest a more “male” appearance in line with my identity. Although others may see it as a drastic change, for me it was like a homecoming. Puberty was a cruel process that alienated me from my body and changed it in ways that felt totally wrong. Although it was a shock at first to see dramatic scars across my chest, I felt an instant reconnection to something I thought I’d lost. Choosing the surgery was scary, expensive and not without risk – but it was the best decision I’ve ever made.

I was extremely lucky that my parents were able to support me financially through surgery. I had already waited nearly four years just to be seen at a Gender Clinic, plus another year of sporadic appointments and being told it would be at least two more years before I could have surgery.

The idea of losing most of my twenties, waiting to live my life in a body I felt belonged to me, was unbearable. Every time I see my scars in the mirror, I am reminded that I made a choice to listen to myself and prioritise my own happiness above the discomfort of others.

For a significant number of trans people that simply isn’t an option.

“Although it was a shock at first to see dramatic scars across my chest, I felt an instant reconnection to something I thought I’d lost.”

In the last year I have seen a huge increase in discourse around “trans issues” in the UK. While increased visibility can be a good thing for people like us, the debates that exploded around proposed reforms to the Gender Recognition Act (GRA) were at points deeply disturbing and frightening for me and the trans community in general.

The intention of the reforms was ostensibly to make it more accessible for trans people to legally change their gender, which requires obtaining a Gender Recognition Certificate (GRC) through a lengthy, intrusive process. Here’s just one example: bafflingly, in a country that prides itself on human rights and freedom of expression, a married trans person must gain permission from their spouse before they can have their gender legally recognised.

When the government eventually announced the reforms they planned to make – after years of consideration and a consultation that thousands of trans people responded to, I was disappointed by how little was changed. But the sad truth is that the opposing voices were so loud, so influential and filled with such fear that I was relieved we didn’t lose any rights.

I struggle to comprehend what makes me, and my now happily boob-less torso, quite so terrifying that others should feel the need to debate my existence. Even as I write this, there is a knot forming in my stomach as I wonder what abuse I may be setting myself up for – I’ve already been called a “deluded woman” and a “gender traitor” more times than I care to say.

“Medically, socially, bureaucratically, transition is a process that takes years of determination and self-motivation, with the burden of proof laid constantly at your feet.”

Alongside a fairer, kinder process of self-identification (like successful models in the Republic of Ireland and several other European countries), what the trans community needs is a healthcare system that isn’t set up to disbelieve them at every turn and can meet the needs of those who need it. Last May, Northampton NHS Gender Identity Clinic, where I was referred and from whom I am still waiting for a testosterone prescription, estimated their wait time for new referrals at 43 months. Waiting times for initial appointments at many gender clinics are now up to four years.

Covid-19 has seen long-awaited surgeries and hormone prescriptions delayed even further While those who oppose trans rights often suggest that medical transition is “too easy” or something that can be done impulsively, the infuriating reality is quite the opposite. Medically, socially, bureaucratically, it’s a process that takes years of determination and self-motivation, with the burden of proof laid constantly at your feet.

By pure coincidence, a filmmaker got in touch with me a couple of days before my surgery, wanting to gauge my interest for a programme about drag kings. I said I’d be unavailable for a while, we got to talking about my transition, and we decided it might be a useful and interesting experience if we made a short documentary about this significant moment in my life. I decided perhaps there would be value in documenting my reality, especially given the prevalence of misinformation about what it is to be trans, and to transition.

Mine is just one experience, and an undeniably privileged one at that. But something I know to be universally true is that to be trans is to be self-aware, to be brutally honest, to pursue authenticity in the face of others’ discomfort and to be brave. Trans people are the ones you want on your team.

Isaac Williams is a trans, non-binary drag king performing under the name Mark Anthony

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Useful websites and helplines:

  • The Gender Trust supports anyone affected by gender identity | 01527 894 838
  • Mermaids offers information, support, friendship and shared experiences for young people with gender identity issues | 0208 1234819
  • LGBT Youth Scotland is the largest youth and community-based organisation for LGBT people in Scotland. Text 07786 202 370
  • Gires provides information for trans people, their families and professionals who care for them | 01372 801554
  • Depend provides support, advice and information for anyone who knows, or is related to, a transsexual person in the UK