Actor Elliot Page first opened up about identifying as transgender in December. Since then, he has been honest about his experience, including what life was like for him before his transition and what it was like to come out so publicly. Now the Juno star is showing off the results of his top surgery that he got as part of his transition process.
On Monday, the 34-year-old posted a photo to Instagram that showed him standing in a pool, wearing swim trunks, smiling. "Trans bb's first swim trunks #transjoy #transisbeautiful," he captioned the photo.
The comments quickly filled with support for Page: "You look amazing. And most of all happy," actress Nina Dobrev wrote. "Hot❤️," singer Miley Cyrus said. "Dude I see why you crushed me on that workout!," his Umbrella Academy co-star Justin Cornwell shared, obviously hinting at Page's abs.
Page first revealed that he had top surgery in an interview with Time in March. He had actually already been recovering from the surgery when he first came out as transgender via his December Instagram post. In the interview, Page explained that the surgery made it possible for him to finally recognize himself when he looks in the mirror, saying that the surgery has "completely transformed" his life.
More recently, in an interview with Oprah Winfrey, Page explained why he chose to speak about his top surgery: "I wanted to talk about it for a couple of reasons. I wanted to share with people just how much it has changed my life. And I want people to know that not only has it been life changing for me, I do believe it is life saving and it's the case for so many people… and because there is such an attack on trans health care right now, when already there is such a lack of access or trans people who don't even want to go to the doctor."
What is top surgery?
To better align with how they identify, transgender people may make changes to their physical appearance, including changes to their clothes, hair, and mannerisms. Physical changes can also come from hormone therapy, which 60%-70% of transgender people are estimated to do, according to the Centers for Disease Control and Prevention (CDC).
Another option to alter physical characteristics is gender-affirming surgery. These surgeries can be performed to change a number of sex characteristics, including the breasts/chest, genitalia, or facial features. The CDC estimates that 20%-40% of transgender people have had at least one gender-affirming surgery. Top surgery—which makes changes to a person's chest—is one type of gender-affirming surgery a transgender person might consider having.
Transmasculine top surgery
What the top surgery consists of depends on what a person is transitioning from and to. For transgender men, like Page, the process of masculinizing often includes top surgery, as Health previously reported. "The goal of transmasculine top surgery is to remove the breast tissue (mastectomy) from both breasts and create a masculine appearance to the chest," according to the American Society of Plastic Surgeons (ASPS). Since there are many techniques used to perform top surgery, there are several factors that you should consider when choosing which technique is best for you, including how much breast tissue there will be, how much excess skin you are OK with, and whether you want to feel sensation in your nipples.
During the same time that you are under anesthesia for the mastectomy, the doctors will also reposition the remaining breast tissue to create a masculine contour to the chest. They may also reduce or reposition the nipple and areola.
"Following your transmasculine top surgery, gauze or bandages will be applied to your incisions. An elastic bandage or support bra will minimize swelling and support the reconstructed chest. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid," per the ASPS. In all, the healing process usually takes several weeks, as swelling decreases and the chest shape improves. While scar lines will improve, they'll never disappear completely.
Transfeminine top surgery
For transgender women, "the goal of transfeminine top surgery is to enhance the size and shape of the breasts to create a more feminine appearance to the chest," according to the ASPS. There are a few techniques used to perform top surgery, which means that you should consider factors like how much you want the breasts enlarged, where you want the incisions, and what type of implant you want, when choosing which technique is best for you.
Similar to the transmasculine top surgery, doctors will put gauze or bandages to your incisions to help you recover. To minimize swelling and support the breasts, you'd also wear an elastic bandage or support bra. Healing will continue for several weeks as swelling decreases and the breast shape improves.
Since hormone therapy itself can lead to breast tissue development, transgender women may or may not decide to have their breasts surgically augmented with surgery, as Health previously reported.
Risk factors of top surgery
As with any surgery, there are potential complications from top surgery. For both transmasculine and transfeminine top surgery, these risks might include bleeding, infection, poor healing of incisions, and loss of nipple sensation. "You'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable," the ASPS says. "Many individuals view this procedure as a necessary step toward alleviating their gender dysphoria."
Having surgery is a highly personal decision. As Page pointed out in his Time interview, being trans isn't all about surgery; it's an unnecessary step for some people. For many, cost is often a big factor in their decision. For example, top surgery can cost trans men anywhere from $3,500-$9,000.
It's a decision that Page is happy he made, as Health previously reported: "For the first time in, I don't even know how long, [I am] really just being able to sit by myself, be on my own, be productive, and be creative," he said in his interview with Winfrey. "It's such an oversimplification to say it this way, but I'm comfortable."
What to know if you’re considering gender-affirming surgery
As the ASPS points out, any gender-affirming surgery should be done for yourself, "not to fulfill someone else's desires or to try to fit any sort of ideal image."
You'll have to find a surgeon and talk with your insurance company about coverage. Both of them usually require that you get a letter of support from a mental health provider competent in transgender health, according to the Mayo Clinic. The mental health provider will determine whether you meet the World Professional Association of Transgender Health standards of care criteria, meaning you:
- Have persistent, well-documented gender dysphoria
- Have the capacity to make a fully informed decision and to consent to treatment
- Are of legal age to make health care decisions in your country (age of majority or age 18 in the US)
- Are managing any significant medical or mental health concerns
You might also consider talking to other transgender people who've had the surgery you're considering getting. "They can help you shape your expectations of what can be achieved and what personal and social problems you might experience during treatment," according to the Mayo Clinic.
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