Disclaimer [ENGLISH]
Disclaimer: This material is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it. It is not intended to provide medical advice, diagnosis or treatment, nor does it replace the advice or counsel of a doctor or health care professional. Reference to a specific commercial product or service does not imply endorsement or recommendation of that product or service by CPCMG.
What is Top Surgery?
- Top Surgery is the removal of chest tissue (breasts).
- These procedures are performed by Rady’s Plastic Surgeons who have training and experience in performing gender affirming surgeries.
- A letter from a mental health provider with experience in gender affirming care is required to schedule a consultation with a surgeon.
Why do teens seek top surgery?
- Patients may experience chest dysphoria related to the presence of unwanted chest tissue.
- For some patients, removal of chest tissue may be the treatment needed to relieve this dysphoria.
- Taking testosterone does not usually change the chest tissue much.
When should a teen be referred to Plastic Surgery?
- WPATH guidelines for Gender Affirming Top Surgery includes the following:
- Must be the Age of Majority (18 in California).
- This is the age at which a person is legally considered an adult and can exercise certain rights and responsibilities.
- There are very few exceptions to this age, but patient cases can be reviewed.
- Hormone therapy for 12 consecutive months unless:
- They were not able to due to so for medical reasons.
- If there is documentation in the medical record explaining why hormone therapy is not part of the transition journey.
- Living in gender role full time for at least 12 consecutive months.
- Can make an informed decision, understand the full treatment and can consent for it.
- Demonstrates understanding of surgery and that it is irreversible.
- If there are mental health concerns like depression, it must be well managed and stable.
- Two letters of referral from qualified mental health professionals.
- Must be the Age of Majority (18 in California).
What is WPATH?
- All providers who support Gender Affirming care should follow the recommendations of WPATH.
- WPATH is the World Professional Association for Transgender Health.
- The main goal of WPATH is to promote evidence-based care, education, research, advocacy, public policy, and respect for transgender health.
Reference: WPATH: Standards of Care for the Health of Transsexual, Transgender, and Gender Non-conforming People
Article written by LGBTQ Task Force and reviewed in consultation with Rady Children’s Hospital San Diego Department of Endocrinology (Gender Affirming Care Team). Edited by TT, D.O. | 08/2024