Bye, Bye, Boobies

Despite the relatively positive media attention transgenderism is getting lately—everyone from Barbara Walters at 20/20 to Tyra Banks to Newsweek have focused on the issue—life after a gender change is no picnic. Even the simple act of using a public restroom is a stressful—and sometimes dangerous—proposition. A 2006 study published in the Journal of Homosexuality found that 32 percent of transgendered people surveyed had attempted suicide.

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Changing genders, or living between genders, is not a decision that should be made lightly, says Angel. "This is not something to play around with. It's not a joke," he warns. "It's a life-changing, altering experience. Once you start hormones, you can never go back. There are 20-year-old kids jumping on this thing. Have they been through therapy? Them saying, 'Hey, how much T [testosterone] do you shoot?' It's this trendy thing to be on T. It takes the seriousness out of what it means to be trans, to have a sex change. It's upsetting to me."

Surgery, after all, has an unsettling finality to it. According to a report published by International Journal of Transgenderism in 1998, as many as two out of every 100 transsexuals report having regrets about surgery. Beretta says he knows of two people who opted to go back to their original gender—one person was only a few months in transition, but the other had to make a full transition back to female.

On the other hand, Downey points out, what she's doing is not much different from women who have their breasts enlarged. "What I'm interested in about trans top surgery is breaking down this gender binary and alleviating some of the social expectations to align yourself with one or the other [gender]," she says. "And I feel like a lot of cosmetic surgery reaffirms stereotypes."

Buck angel comes clean about boob-removal Parties: HE HATES THE VERY idea. photo: Alana Cundy

It is hard to put an exact figure on the number of surgeries or transgender people in the country. The U.S. Census Bureau does not track such statistics. Nick Gorton, a female-to-male doctor who works at Lyon-Martin in San Francisco, says that because of privacy concerns, many trans people don't allow their data to be recorded for fear of discrimination by insurance companies and employers. But the sense is that the trans movement is growing; Buck Angel says that transgendered people are the "world's fastest-growing population," pointing out that last year's Transmarch in San Francisco drew 8,000 people. Gorton says that extrapolating from a population study out of the Netherlands suggests that there are 5,000 trans men in the U.S. It's a number he thinks is too low. "Using that, there would be exactly 13 FTMs in all of San Francisco. I saw more than that between last week and today," he says. More likely, he thinks that the number is closer to 15,000.

Gorton has a favorite anecdote to illustrate how transitioning has become so common, it's almost run-of-the-mill. At a conference a few years ago, Gorton ran into his former college roommate—who, it turned out, in the time since they'd last seen each other, had also become a man.

If top surgery has become more popular, it's partially because there is more access to information. Beretta credits the Internet for spreading the word: Websites like transster.com show results from different surgeons, and people find Beretta on MySpace routinely. Partially because of this visibility, top surgery is now a more popular option than it was 30 years ago: "People only change when the pain of changing is less than the pain of staying the same," Gorton says.

Dr. Michael Brownstein, who is considered one of the best top surgeons in the U.S. and was featured in the movie Boy I Am, says that he became known for trans surgeries "purely by accident" in the late '70s. Since he started, the demand for the procedure has increased. Now, he says, "I do four to six of these a week. It's been like that for a few years. Early on, there were very few."

Downey says the three surgeons she was in contact with "were all booked. They're doing surgeries three times a day, five or six days a week—and not all of them, obviously, are top surgeries, but a high percentage were trans- related surgeries. It's a lot."

She was surprised to learn how popular the procedure has become. When she called a friend in San Francisco to announce her plans, she was shocked to hear her friend say that top surgery is all the rage. "She was like, 'You have no idea how many people are having this surgery. The shit is a crazy trend.' " It bothered Downey to think that something so serious could be considered trendy. "I was like, 'Well, why would you say a trend? This is not a tattoo. This shit is so expensive, and it's so physically painful, that how can you possibly call it a trend?' " says Downey.

FTM visibility in particular has led to a heated debate in the lesbian community about "butch flight," something that was addressed in Boy I Am. Identifying as a butch in the lesbian community means taking on a visible—and much respected—role. So when those who are perceived as butch decide to transition to men, some in the lesbian community feel betrayed.