So, I have some news to share and I’m not sure this is something I was really planning on sharing. It turns out that sometimes hormones and a second puberty is not enough to fully develop all aspects of being a woman. Sometimes, the process needs a little help. I’m currently on my way back to Montreal. This time, I’m getting breast augmentation surgery.
Development
When transitioning, some of the key milestones that one hopes to come across, are the ones that are stereotypically associated with the gender that you are transitioning to. These are sometimes referred to as secondary characteristics. For trans women such as myself, there are the softening of the skin, the fat distribution, reduction in body and facial hair as secondary characteristics. As mentioned in previous blogs, I had chosen to complete bottom surgery earlier in 2024 as I felt it was more aligned to how I feel. If you are lucky enough, breast development occurs as part of the second puberty. In my case, I’ve had little growth since about month 6 of taking hormones. I am aware that there is the possibility that there could still be more growth, but now that I am nearing 2 years of hormone therapy, that possibility is getting less and less likely. So, I’m taking matters into my own hands.
I didn’t think I would be at the point that I felt this was necessary, nor did I feel that Cathy and I had the financial security to get this done so soon after bottom surgery. It is one of those things that sneaks up on you though. When you get out of the shower, or wake up in the morning, and you look at yourself and realize that something doesn’t line up with the rest of me. My brain knows that I should see something other than my ribs sticking out from my shirt. Thankfully, I have never had any comments regarding the lack of breast growth, but I see it…and I know it. We’ve made some financial sacrifices to allow this to happen this year, and while our debt is getting a little high, we have a solid plan to help to keep it in control.
Consultation
While I was in Montreal back in late-May/early-June, I decided to meet with Dr. Belanger who, amongst other things, specializes in breast augmentation surgery. It was my last day at Asclepiade and my pain levels weren’t too high, but I remember not being able to sit in the waiting area. The first step in the consultation was to get a full scan done with a 3D imaging system to analyze my torso. I then met with Dr. Belanger in her office while we looked over the scan and discussed options. I mentioned that I just wanted something proportional with my frame, and to look somewhat average. Using the software, we looked at a couple of sizes and shapes and settled on 650cc for the volume. While that may sound big, you have to remember that I don’t have much to work with, and my chest diameter is about 38 inches. I currently wear a 36A bra because 38A bras are not usually in stock at most of the stores at home. Even with that small size, I struggle to fill the cup.
We then discussed material, texture, and position. While there were a few options, it was clear that Dr Belanger had favourites to use. These included non-textured (due to recent studies that indicate they may cause problems), gel (because they are now made such that replacements are not really required) and under the muscle (mostly because of the more natural look and the lack of material to start with).
Once we selected a size, it was on to a fitting room where there were some inserts that I could use with my current bra to see what size really fit my body the best. They had set out 600cc, 650cc, and 700cc. It was a little awkward trying to gauge the appearance but the 650cc did seem to be the most appropriate for my frame, but I wasn’t convinced that they had the right profile.
Picking a Date
Shortly after returning home from Montreal, I received a quote and a request for a down payment to hold a date. It turned out there were many options through the fall and pretty much every Thursday through October. I went through with booking it and picked the date closest to my birthday as I figured this would be a pretty good birthday gift.
Alternatives
I looked into another couple of places more locally here in Atlantic Canada, but they had a couple of things not working in their favour. First, they were not familiar with trans breast augmentation. When I asked, they said they had done a few but it is more rare. That was a red flag for me as I know that my torso is not shaped like cis women and I was afraid that I would not be happy with the result. Second, the consultation dates were into next year. I believe the consult for one was at the end of March and then there would be the wait for the availability for the operating room. I would have been very happy to have this done in New Brunswick. Having the closeness and the availability for help during recovery would have been a plus. In the end, I chose going to a location that I knew would treat me properly, would be familiar with my situation and I was also familiar with. It turns out, that the costs for all locations that I looked at were the same. It’s around $10,000 in case you were wondering.
Funding from Province?
One avenue I have been working on is to see if the province of NB would be willing to pay for this gender affirming care. It specifically states in the Department of Health’s web page that only top surgery for FTM would be covered and that the surgery that I am looking at would not. That didn’t stop me from trying. I was very fortunate that my therapist was onboard to assist as I know that the effort from his part is not small. He went out of his way to craft a wonderful letter explaining why this is necessary for me and why there is a need for the surgery. Essentially, he was classifying it as medically necessary.
To our surprise, I was not immediately rejected. There were some requirements for follow-up as the approving doctor needed to understand more about my situation and have another medical professional’s opinion. At first, I thought this would have been too time consuming and invasive, but as I was with my family doctor for another appointment just last week, I brought up the request.
Part of me would love to have the financial assistance from the province to help pay, but part of me also just wants to know that it can be done. We are one of the only (if not the only) provinces in Canada that does not provide any funding for MTF breast augmentation. I was liking the idea that I might be one of the first to see if it was possible. Maybe even create a play book for other trans women here in NB to help them get funding.
My family doctor put something together and sent it off to the provincial approving doctor that detailed my request and my need. I also made sure that I had all of my hormone prescriptions listed, my blood work test results showing that they have been effective, as well as my history of body measurements that I have been doing biweekly since I started taking hormones. This was last Friday though, the Friday before my surgery on the following Thursday. I knew that it was unlikely that I would get anything in time, but then again, if I could get approval, it would be a very large victory for the trans women here in New Brunswick.