Is it possible to have a mastectomy performed for non-medical reasons?

I'm 24 years old, a B/C cup. My breasts can be uncomfortable, I don't like their shape, and I've been stressed because of them. I'm unsure if I'm entirely cisgender. I identify as female, but sometimes I feel less female and more male, but a feminine male. During those times, I prefer male pronouns, and I want a penis, but I wouldn't want to irreversibly change my physical sex. If my breasts were removed, I could still present as either gender, and I feel I would be more comfortable in my body.

Doctor Answers 1

Breast removal with respect to gender issues

First of all, congratulations on owning who you are and the fluid nature of how you want to live. There are several ways to answer your question depending on what concerns you most: 

  • If your primary concern is breast cancer risk, going with a nipple sparing mastectomy with reconstruction that creates a size and shape that answers to your need to have a more neutral, rather than feminine, appearance would be a good idea. This can be done with a small implant, or with fat grafting, depending on how much you want to change.
  • If it is more of a cosmetic concern, a standard breast reduction is always an option.
  • If you don't want extreme surgery, but want less volume, body sculpting with a combination of skin tightening, liposuction, and glandular tissue removal with a percutaneous device like the EnCor is possible as an out-patient and with no real "incisions" just nicks in the skin to allow the probes to be placed. This may have the least impact, but will also look the most natural. An ultrasound of your breasts would be helpful to see what options are realistic. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.