Do you have to be on testosterone to have top surgery? Would the surgery work if your not?
Misha
 

Hey Misha, first of all, thank you so much for your question. Accessing gender-affirming surgeries can be super complicated, legislation is widely different from one country (or region) to another. When I first started my medical transition, I felt completely lost and alone. It makes me super happy that I am now able to answer your question and give your recommendations to access gender-affirming care in Québec.

Good news, in Québec, you do not need to be on testosterone to access top surgery! The Quebec government doesn’t require you to be on hormonal replacement therapy (HRT) to get top surgery.

The first step to getting top surgery is calling the GRS (https://www.grsmontreal.com/en/home.html) it is the clinic where every gender-affirming surgery is done in Montréal! Ask them to email you all the documents to apply for the double mastectomy, be insistent that you want them emailed, it is way faster.

In the meantime, you will need to get an appointment with a doctor to fill up the specific form that the GRS provided you and get a list of your prescribed medication print out by your pharmacist.

After filling up the form with a doctor,  you will need a letter of recommendation by a trained social worker, sexologist or psychologist. I recommend Catherine Beauséjour at the Camélia clinic! She’s the one who got me my letter and she was non-binary friendly! Sadly, with many health professionals, you will need to play the “I was born in the wrong body” discourse, it is what health professionals are most responsive to, but don’t forget that you are allowed to get a top surgery even if you aren’t on testosterone!

Technically it won’t affect your result, but a surgeon might say otherwise. Testosterone redistributes fat in a more “masculine” pattern, meaning that fat from your chest slowly redistributes to your belly.

Getting top surgery without being on testosterone won’t negatively impact your health and your chest will heal properly, you might you get some misplaced recommendations from surgeons, saying the shape will look more “natural” if you got start HRT. But don’t forget, you are the only person who can decide what transition will look for you!

I hope this answers all your questions, don’t be shy to send any follow-up questions!