Gender and gender identity are very personal.

They are individualized to fit your perceptions and feelings of who you are.

It is not one size fits all.

Not all transmen are the same nor are all gender nonbinary or gender expansive the same.

Perhaps, gender and gender identity are like your fingerprints – they are different from everyone else.

Testosterone and Gender Affirmation

When it comes to testosterone, the same holds true.

A vast majority of female-to-male (FTM) individuals take testosterone.

But not all.

They have their reasons.

A lower percentage of female-to-gender nonbinary (FTN) individuals take testosterone – again based on their own reasons. Not only that, if they do take testosterone, many titrate their dosages to obtain the manifestations or effects that they are seeking from this hormone while trying to avoid other changes.

In essence, you can “have it your own way”.

Is Taking Testosterone a Requirement for Top Surgery?

Whether you are FTM or FTN, it is your personal choice whether or not to be on testosterone.

That’s great but will it affect your ability to have top surgery?

The short answer to this is NO.

Whether you are seeking either FTM or FTN gender affirming top surgery, there is absolutely no requirement that you must be on testosterone prior to the procedure. The position is different, however, when it comes to MTF top surgery which is not the topic here.

Can I Start Testosterone after My Top Surgery?

Most transmen, gender nonbinary and gender expansive individuals have already made their decisions whether or not to take testosterone prior to actively pursuing gender affirming top surgery.

But not all.

There are some individuals, largely gender nonbinary and gender expansive, who for a variety of reasons either want to wait until after surgery to start testosterone, are actively debating the issue but haven’t reached a definitive decision or are not planning to do so but may consider it in the future.

So, the answer to this question may be quite evident now: yes, you can start testosterone after having undergone gender affirming top surgery.

Will Starting Testosterone after My Top Surgery Negatively Impact My Results?

Staring testosterone after having undergone either FTM or FTN top surgery should have absolutely no direct impact on the results. It will not degrade the appearance of your chest or cause some undesirable complications involving the scars or remaining skin. Yes, there can be an outbreak of acne but this would have occurred regardless of if you did or did not have surgery.

You may grow hair on your chest or, with extensive weight training, increase the bulk of your pecs to give more fullness, definition and a more masculinized appearance but again that is not degrading your top surgery results.

How Soon After My Top Surgery Can I Start Testosterone?

There is no one definitive, correct answer as to when you can start taking testosterone (for the first time) after top surgery and for several reasons. Theoretically, you could start it the day after surgery and it likely will have no impact on healing or your risks. However, there may be an impact on one’s emotions and mood which already can be unsettled in the peri-operative period.

Generally, it may be a more prudent choice to wait at least three to four weeks after surgery before starting the testosterone.

If you are considering first starting testosterone after your top surgery, ask your plastic surgeon for their recommendation.

Your Consultation

If you are considering either FTM or FTN gender affirming top surgery and would like to schedule a consultation, you can contact my office at the Arizona Center for Aesthetic Plastic Surgery by either calling (480) 451-3000 or by email.

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

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