The troubling truth about ‘gender affirming’ mastectomies

When Sinead Watson had a double mastectomy in June 2017 at the age of 26, she was initially ‘quite euphoric.’ Although born female, she had been taking testosterone for two years and was using the name Sean. The mastectomy, or ‘top surgery’, was the last step on her transition.

‘I was so glad that I’d finally got it done – no more binders, no more being paranoid that I was a man with boobs –  so I did feel really good about it,’ she says. After the surgery, however, she discovered she had no sensation at all in her chest area, something that continues to this day.

‘I realised after about five months my depression and self-hatred was still present, and that the surgery didn’t ‘cure’ me like I thought,’ she says. ‘The complete lack of sensation in my chest is unpleasant, and I realised in 2018 I regretted not only the surgery – I regretted transition as a whole because I still hated my body.’

Top surgery is on the rise among young women feeling unhappy with their female body, and social media sites such as Instagram and TikTok are awash with pictures of young women showing off their newly flat chest and scars – on Instagram, the hashtag #topsurgery has 262,735 posts. Even the computer game The Sims allows users to create characters with top surgery scars. Freedom of Information figures show that, in 2022, the Wales Gender Service made 172 referrals for top surgery.

Some of the women who opt for double mastectomy as part of a gender reassignment process are very young: in the past six years, 51 teenagers aged 16 and 17 were referred from Scotland to hospitals in England to undergo further assessment for ‘specialist chest reconstruction’.