Cis men love top surgery—it should be available for all

Men who get top surgery often describe the medical procedure as life-changing.

A recent New York Post article interviews just a few of the tens of thousands of people who have gotten gender-affirming top surgery to reduce breast tissue, and what they have to say is clear: This medical procedure is needed.

According to a recent report from the American Society of Plastic Surgeons, 26,430 breast reductions were performed on cis men in 2024, up from 20,955 in 2019. This makes it the most popular form of plastic surgery performed on males, surpassing liposuction.

The firsthand accounts from men who have received this type of gender-affirming care should move anyone who reads them. Still, politicians and public figures on the right are regularly calling for gender-affirming surgeries to be banned, and often call procedures like top surgery "mutilation" or "abuse".

"It changed my life," Lewis Gonzalez, who got the surgery in 2021, tells the New York Post. "I had to get used to walking with my chest out and having confidence. Before, it felt like I was carrying around a big bag of rocks – that's what my gynecomastia was."

Gynecomastia is breast development in males and is most often caused by hormone levels. It's wildly more popular than you'd think.

According to the National Institute of Health, "up to 60 percent of boys have clinically detectable gynecomastia by age 14." Boys who develop gynecomastia typically have a decreased androgen-to-estrogen ratio.

Pubertal gynecomastia usually resolves within three years, but for thousands of men, the problem never goes away. Elevated estrogen production, androgen overproduction, and decreased testosterone in adults can all contribute to gynecomastia.

In 2024, over 26,000 American cis men received gender-affirming surgery in the form of breast removal. That number has been steadily growing and is up more than 10 percent from the previous year.

Kelbin Ramirez, who had the surgery when he was 30, tells the Post that trying on clothes was torture as a young man, because he "would go into the fitting room and get so emotional and frustrated because no matter what I wore, they were still so prominent."

"I tried to wear stuff that I really liked … but at the end of the day, under the clothes, they were always there," he says. "And I always felt it."

Cis men and trans people have a lot to empathize with each other on this issue.

No one should be forced to live with that kind of pain day in and day out. If someone is suffering in this way, the compassionate thing to do, no matter what the person's genitals or chromosomes are, is to perform surgery.

The high rate of male top surgery also does something else: It shows just how weak the Right's binarist, gender-essentialist foundation of their worldview is.

Just the fact that higher estrogen levels are so typical in boys and men alone chips away at the anti-trans argument that sex is binary and unchangeable. It also shows the double standard conservatives have when it comes to people who were assigned male at birth and people who were assigned female at birth.

Gynecomastia surgery is, by definition, gender-affirming care.

If society treated boys with gynecomastia the same way it treats cis women who have elevated testosterone levels, we'd see them being banned from sports and single-sex facilities. Thankfully, that's not happening.

Banning these surgeries for trans men and nonbinary people also endangers cis men's abilities to get the surgery. The NIH states that 1 in 600 to 700 males have Klinefelter syndrome, which means a man has an extra X chromosome, and often "prominent gynecomastia." If a male patient goes in for the surgery and finds out he's actually intersex, does that change his right to access this type of healthcare?

The 14th Amendment to the U.S. Constitution says that neither the United States nor any individual state has the right to "deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."

Denying adults who were assigned female at birth legal access to medical procedures that tens of thousands of cis men have access to goes against the very heart of American freedom.

Banning trans people from getting top surgery isn't about "protecting girls," it's about controlling bodies. And as long as the government can control some people's bodies, it won't stop trying to control everyone's.

"If you do the surgery, do it for you," Gonzalez says at the end of the New York Post's article. "At the end of the day, it's all about how you feel about yourself."

Unfortunately for trans people, that's not all it's about. It's also about what your government officials will allow you to do.

It's clear to anyone with a brain or a heart that the people in the article needed this surgery and that it was worth the pain and fear. If only conservative politicians were included in that group, they'd understand.

Mey Rude is a staff writer for Out. Find her on Instagram @Meyrude.

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