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There is an abundance of misconceptions and questions regarding testosterone and FTM top surgery and, to a far lesser extent, FTN top surgery. This is quite understandable given the rapid changes that are occurring in various areas of transgender issues. Below, we will look into four of the more common questions that patients have.

Is Being on Testosterone a Requirement for FTM or FTN Top Surgery?

Whether you seeking female-to-male (FTM) or female-to-nonbinary (FTN) top surgery in order to address your gender dysphoria, there is absolutely no requirement that you must be taking testosterone before the procedure can be performed. It is your personal decision to make regarding being on testosterone – before or after your gender affirming surgery.

Whether or not you are on or will be on testosterone is a personal choice that only you can and should make. A vast majority of patients seeking FTM top surgery are already taking testosterone for relatively obvious reasons. Many FTN individuals, especially those that are transmasculine, do so as well.

Must I be on Testosterone in Order to be Able to Obtain Insurance Approval?

All the major health insurance companies that do cover FTM and FTM gender affirming top surgery, do not require that you are on testosterone in order to obtain approval for coverage. That is particularly good if you have decided that testosterone is not right for you.

With that being said, even though your insurance company does offer coverage for top surgery, you should check to make sure that your specific plan has that benefit. Not all plans will provide coverage.

Do I Have to Stop My Testosterone Prior to FTM or FTN Top Surgery?

If you search the internet, you will find conflicting answers to this question. Then again, at least for a period of time, there were also conflicting medical opinions on this especially requiring it on a routine basis. The concern was that testosterone increased your risk of developing blood clots in the leg and lung – occurrences that could be quite consequential, even deadly.

The general consensus now is that testosterone does not routinely need to be stopped prior to top surgery. However, there are exceptions to this based on medical history, weight and other factors. This would be discussed at the time of your consultation.

Is Starting Testosterone After Undergoing FTM or FTN Top Surgery a Problem?

There are some individuals seeking either FTM or FTN top surgery who are contemplating whether or not to take testosterone. The reasons for their hesitancy can be many. Regardless, they definitely want to have the surgery and then make a decision regarding taking testosterone sometime later on.

Will this have an adverse impact on the results of their previously performed top surgery?

Definitely not!

In fact, the testosterone can help improve the postoperative chest contour both by allowing for hypertrophy of the pectoralis muscle (enlargement) and by reducing the fat deposition. Weight training and working out can have an impressive and positive impact on the shape of the chest resulting in an even more masculine and, potentially, muscular appearance.

Scheduling Your Consultation

If you would like to schedule a consultation for top surgery, please call the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or contact us by email.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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