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Bex Taylor-Klaus is an American actor best known for their onscreen roles in television shows such as “The Killing,” “Scream,” “13 Reasons Why,” and “Arrow,” as well as voiceover work for several animated series. But outside of acting, Bex is so much more.
As a transgender non-binary person, Bex embarked on a journey to feel more comfortable in their own skin, and this led to their decision to undergo what is known as “top surgery.”
Masculinizing chest surgery, also known as transmasculine top surgery, is a procedure designed to remove tissue from the breasts and reshape the chest to create a more masculine or non-binary appearance.
Bex came to Bedford Breast Center and underwent top surgery with Dr. Heather Richardson. They recently sat down together to talk about Bex’s top surgery journey.
While on the surface it may seem like a relatively simple procedure, there are several important factors – both physical and mental – that should be considered before undergoing top surgery.
With this in mind, Bex devotes much of their time to helping others in the LGBTQ community find support and resources to ease the challenges of their journey to define who they are. “I am a lucky, very privileged person,” Bex says. “I was lucky enough to have an incredible support system, and I know there are a lot of kids out there like me who don’t have that.”
Why is Top Surgery Performed?
Transgender men or non-binary people may experience what’s known as “gender dysphoria,” which is a feeling of discomfort that stems from their gender identity being at odds with the gender they were assigned at birth.
Top surgery offers a natural solution to that feeling, as it shapes their body in a way that more accurately reflects on the outside the way they feel on the inside.
For some people, it is an easy decision, but for others it may be more of a process. Just like any plastic surgery procedure, it is important to choose to undergo surgery because it will improve your quality of life, and not because you feel that it is “expected” or that you should conform to an ideal around your identity.
Everyone is different and relates differently to how they feel in their body, so the decision to undergo top surgery is highly individualized.
What is Required Before Undergoing Top Surgery?
In many cases, top surgery may be covered by health insurance. However, most insurance companies and surgeons require a letter of support from a licensed mental health provider who is well-versed in transgender mental health. Bex began exploring their options, and quickly realized that they needed to ask for help.
“The healthcare system in America is scary to navigate alone, especially as a trans young adult who wants to do all their healthcare stuff alone. For all you trans kids out there who want to do it all alone – don’t. I know that there is some sick, twisted need to do it alone that we all have, but it won’t help us in the long run. The only thing that actually helped me and brought me to Dr. Richardson was reaching out to my family.”
The World Professional Association of Transgender Health (WPATH) have put forth standards of care criteria for the surgical treatment of gender dysphoria, designed to ensure that patients are receiving optimal care. Your mental health provider will determine if you meet the criteria, which state that patients must:
- Have persistent and well-documented gender dysphoria
- Be able to make a fully informed decision and to consent to treatment
- Have reached the “age of majority” required to make healthcare decisions in your country
- Significant medical or mental health concerns that are identified must be reasonably well controlled
If you meet the above criteria, your provider may write a letter of support for the insurance company and your selected surgeon.
Preparing for Top Surgery
When searching for a surgeon to perform top surgery, it is important to know that while there are surgeons who may be experienced in the type of surgery required for your ideal results, there are no official specialty boards or societies specific to gender surgery that certify or oversee surgeons who offer these procedures.
It is vital that your surgeon is board-certified in plastic surgery, experienced in breast reconstruction procedures, and sensitive to your needs and desires around undergoing top surgery. Understanding that many people seeking top surgery may not have the support or resources to ask for help, Bex suggests looking online at sites like The Trevor Project for more guidance.
“The Trevor Project actually has some great resources for all kinds of different things for trans kids, including help lines. I would call the Trevor Project and ask for help and ask for recommendations.”
Surgical Techniques for Top Surgery
Once you’ve selected your surgeon, it is time to consider what surgical technique will offer the best results. Top surgery is broken into two broad categories: nipple sparing vs. nipple grafting. In both cases, once the breast tissue is removed, your surgeon will then reposition your remaining tissues to create a more masculine contour to the chest.
Nipple sparing surgery is typically best for those with a small amount of breast tissue, good skin elasticity, and smaller nipples.
The procedure does not remove much skin, only the breast tissue underneath, and nipple sensation is preserved, as the nipple is left in place. However, because the nipples of an assigned male are smaller and more widely set than those of an assigned female, the aesthetic may not be as “typical” as expected, and patients may want to undergo nipple revision surgery in the future.
At our medical center, about 95% of our mastectomy patients undergo successful nipple sparing surgery, and our highly experienced surgeons have pioneered reconstruction techniques to preserve as much sensation in the chest as possible.
Nipple grafting surgery is used for those patients who have larger chests or require reshaping of the nipples in order to achieve the optimal aesthetic result. The surgery entails a double incision mastectomy, followed by free nipple grafts. There is a risk of nipple loss and loss of nipple sensation using this technique. However, this doesn’t always have to be an accepted side effect.
At Bedford Breast Center, we offer sensation-preserving mastectomies, which involve repairing the nerves that are severed during mastectomy surgery. Once the nerves are reconnected, patients can expect nipple sensation to return within six months, with more sensations spreading across the chest over the course of a year.
When deciding which technique best meets your needs, keep your aesthetic desires in mind as you discuss which surgery is right for you. Nipple placement, as well as length and position of scars are things to consider as you continue your top surgery journey.
Recovery and Results
Post-surgery, your chest will remain in a tight compression wrap for several weeks. You’ll likely have one or two small drain tubes placed where your chest tissue was removed to drain any fluids that typically accumulate after surgery. The surgeons at Bedford Breast Center will provide you with detailed aftercare instructions and follow-up appointments – be sure to follow them closely and give yourself time to adequately rest and recover.
An important thing to remember is that even though breast tissue was removed during surgery, and further growth of breast tissue is suppressed with hormone therapy, your risk for developing breast cancer still remains. Be sure to monitor your breast health with regular self-exams and undergoing regular screenings as directed by your doctor.
The results of your top surgery can relieve the feelings of gender dysphoria, and lead to more confidence and less anxiety associated with your appearance. Research has revealed that transgender men and non-binary people who underwent top surgery were highly satisfied with the results, and were overall more comfortable engaging in activities they may have avoided before surgery.
Bex is thrilled with the results of their top surgery, and encourages transgender people to find a like-minded community for additional support.
“There are ways to find, not exactly trans support groups, but a trans community. I started finding mine by going to Trans Pride in Los Angeles a couple years ago, so the Los Angeles LGBT Center probably has a lot of really good resources.”
If you’re still struggling to find resources, Bex reiterates their willingness to help; “Trans kids out there, wherever you are, look in your city – and if your city doesn’t have [a community] reach out to me on social media and we’ll see what we can find.”
Contact Our Medical Center For More Information
Bedford Breast Center provides a full spectrum of breast care for patients, from regular screenings to breast cancer treatment. Our surgeons have developed proprietary surgical techniques to ensure patients enjoy the best possible cosmetic and medical outcomes. To learn more about our services, contact our Beverly Hills medical center today.