JJ’s top surgery: Part 2

When the surgical team converged to wheel JJ off, I succumbed to my terrible fear. JJ was being taken away as they had been the moment they were born, when they were 3.5 pounds and I was not allowed to hold them. 

I had seen JJ emerge from me—I saw their beauty. It was like seeing a leopard being pulled out of my body. Their lithe self, their strange eyes.

So that now, with JJ on the gurney, I wanted back the comfort of home. The bed I slept in so well. I wanted back the version of the child I knew so well—even slumped as they were. Miserable in their body as they were.

The anesthesiologist injected JJ with a painkiller. It was a direct shot to the chest, a long needle. JJ was going under. 

Right before they did, they turned to me and said, with a terrible seriousness, “Don’t ever ask me if I regret this.”

Cookie cutter

Prior to this moment, JJ and I had met Dr. Hammada just once, at the consult. But he made a powerful impression with the intensity of his gestures and the gleam like actual genius in his eyes as he discussed his approach to recreating JJ’s chest.

JJ, who identifies as tras masc, wanted a male chest. (Being nonbinary, they have never expressed interest in bottom surgery.)  

Dr. Hammada explained that nipples on male chests are positioned differently than on a woman’s. He described a set of “cookie cutters” he had designed for various nipple shapes, clearly proud of his invention. After removing JJ’s nipples, Dr. Hammada would graft skin from the areola and reposition new nipples on JJ’s new chest. He explained that pectoral muscles are essentially what creates the shape of the chests they admire and suggested they start lifting some weights prior to surgery. He invited JJ to share images of chests they liked with him via email.

We spent the night before surgery in a nearby hotel after driving the two and half hours to Boston. JJ, predictably, ordered room service with abandon. We would return to the room after surgery, which was estimated to take five hours. Dr. Hammada’s office told us to stay close in case of complications.

Now it was really happening. “Goodbye Mom,” the nurse said, “we’ll call when it’s over.” 

And I walked out alone, without my baby, as I had on each of the 30 days they were in NICU. I was so worried. I had always been worried. How had I made this person? 

How I feared for their survival as I gazed into the glass incubator box. They were curled up, tiny and yellow, not unlike a trussed chicken.

How I feared for their survival when they were 11 and slumped down into their body! How would I know how to help them, I wondered. And still wonder. As any parent does.

Rigid

During the surgery, I drove around. I found a Pilates class and took it, desperate to distract myself. Then my cell rang.  

Surgery had gone well. 

Dr. Hammada noted that JJ didn’t have much definition in the pecs, which wasn’t surprising, as they had not followed up on the suggestion to lift weights.

But he was pleased with his work. Despite the lack of musculature, he had introduced some tissue from the breast to create a more flattering contour.

The next time we saw Dr. Hammada was two weeks post surgery. We had brought the promised Litter Box Cake. It was surprisingly heavy (could it be the pudding?). JJ and I struggled it out of the dark parking garage together, the candy “turds” I had artfully scattered over the cookie-crumb “litter” sliding around. 

Dr. Hammada, however, was all business. He had his assistant move the cake out of the exam room. I was irritated that he didn’t notice our offering. I spent half a day making it!

Then he took off JJ’s bandages. 

I had not seen JJ’s chest bare since they were maybe ten. Before puberty.

“Mom,” the doctor said, “come take a look.”

I looked. It was remarkable. 

You could see the lines where the stitches had been. The chest looked exactly like a male chest. It was a male chest. And it was beautiful. 

I realized right then that this surgeon is actually an artist.

A promise

“Don’t ever ask me if I regret this,” JJ said before going under.

“I won’t,” I promised.  

In asking me, I think they were addressing the lie, spread by anti-trans people, that trans folks who have top surgery regret it. Such tactical hate annoys JJ. As it annoys and enrages me.

Even before JJ decided on top surgery, I had come to trust that they know what they want and need.

I will never regret supporting JJ’s gender affirming care. The crushing Binder is a thing of the past. JJ’s stooped, painful posture is a thing of the past. JJ stands tall, and they participate in athletics with confidence. As a straight-A student on the honors track, they now spend the majority of their time on academics instead of on feeling bad about their body. 

JJ is now 16. Are they still happy with their top surgery? “Oh, yes,” they say.

I cannot close this essay without mentioning that a year or so after JJ’s procedure, a mom friend from PFLAG took her own nonbinary kid to Dr. Hammada for top surgery, and he mentioned that JJ and I had brought him a Litter Box Cake.

“Really? I was always pissed because I was sure he didn’t eat it.”

“Oh, no,” said my friend. “In fact, he said it was delicious. The whole staff devoured it.”

— T.C.