Dissatisfaction with their breasts is a common issue for transmen, who are biologically female but identify as male. Even if they have been living as their desired gender for some time, “passing” as a male may be difficult if the breasts are quite prominent. As a result, some transmen decide to undergo subcutaneous mastectomy.
The goal of subcutaneous mastectomy is to make the chest appear more masculine. Breast tissue and excess skin are removed, but the nipples are preserved, reduced, and repositioned. Surgeons also remove the inframammary fold – the area where the breasts and chest meet.
Mastectomy can have significant psychological benefits for transmen. Appearing more masculine can help them feel more comfortable and confident in social situations and sexual relationships.
In 2016, the Journal of Sexual Medicine published a study involving 33 patients who were undergoing mastectomy as part of their female-to-male transition. Before their surgery, the patients completed questionnaires designed to evaluate their feelings about their bodies, their self-esteem, and their quality of life. Between six and sixteen months after surgery, the participants completed these assessments again.
Generally, the transmen saw improvements in their body satisfaction, self-esteem, and quality of life after their surgery. However, the study authors noted some “residual body image issues” and suggested that some transmen may need more time to adjust after having a mastectomy. Psychological counseling might help as well. (Read more about the study here.)