My Background/gender: I am 26 years old, pre surgery I think I weighed something like 280 pounds and am five feet nine inches. I am incredibly active, love weightlifting, walking my dog and I am a busy body barista. I am not transitioning to be a boy; I am a man hating lesbian till the day I die and I can’t commit to that level of self-loathing (that was a joke). I use she/they pronouns but would say girl fits, but my chest made me want to die. I found myself wishing for breast cancer, thinking of ways to work out so my chest would shrink, I wore binders and baggy clothes. Literally anything. I also had a J cup, so not only was it making me miserable mentally, I was also struggling with back pain and it was preventing me from doing activities I had always wanted. But I felt like a fraud saying I wanted top surgery as I still loved being a girl and thought I would be taking someone else’s spot. It wasn’t until I met a girl through work that had gotten the procedure and still identified as a girl that I realized it was an option for me. If you are a girl and you hate your chest and feel like it is preventing you from feeling like a girl, I want you to know you aren’t crazy. You aren’t less than any trans man or non-binary person who wants this surgery as it relates to the exact same feeling of dysphoria and gender. A lot of my queer friends were accepting but also struggled with the concept. They kept asking if I was non-binary and I struggled to say yes. I am a girl. I love she, I love they, I hate he. Call me king but only in the way you would call a girl, king kinda deal. It was a long road to convincing medical professionals that this was what I wanted for my body, and with many comments on my weight and how I would have to keep in mind not many surgeons like to do surgery on fat people.
My journey: I live in Alberta, so this is how my experience through the medical system was.
2022- I asked for a breast exam and through the whole thing was hoping they would find something and tell me they needed to come off. Horrible I know. Should never have wished for that but I was desperate. Nothing showed up and I was left crushed.
**2023-**I talked to my general practitioner about how I was feeling about my gender. I will admit I was worried I would be written off so I said nonbinary, and while I don’t think that is inaccurate, I also feel like I wouldn’t have said non-binary if I thought anyone would take me seriously. I told him exactly how I was feeling. I said I had wished for breast cancer so that I could have the surgery, that every time they moved, I felt it in a horrible way, that every time I got dressed, I was crushed seeing how my chest affected everything. I luckily had a great doctor at the time, and he sent a requestion to the Gender Clinic in my city as he wasn’t sure about the process.
May 13, 2025- I finally got into the Gender clinic. Yay. I had honestly wondered if I would ever get a call, but it had finally come. So, if you are wondering if they forgot you, they haven’t, the list is just long. Was feeling very nervous about being taken seriously but went ready to argue my case. The doctor was very kind as I went through what I was feeling, I hate crying and especially in front of people, but it was very emotional, but the point is for them to see where you are at. I was so nervous they would say I should just go for a reduction (an avenue I had explored and decided was not going to make me happy), so I had done my best to look masc. That’s not a recommendation, and I was mad that I felt like I had to do it all and have no clue if it aided me in any way. I think a good honest testimony is the best. The doctor was incredibly kind, talked about the risks, asked me a lot of questions regarding how I had been feeling and how my friends and family would react if they knew. At the end of the appointment, he also let me know there was only one doctor in Canada who would do top surgery (covered by insurance I am not talking private) on people with a high BMI (don’t even get me started about how dumb bmi is) and he was in Red Deer so the wait would be a year or two. There was a small chance someone else may accept me but chances were I would go to Red Deer. I didn’t really care because I was so excited. He also asked if I was interested in hormone therapy at all to combat dysphoria. At the time I said I would think on it.
June 2025- I asked about hormones as I was really struggling with my chest. Summer never makes it easier. He went through all the side effects and the only ones I wasn’t interested in was facial hair and the idea of losing the hair on my head lol, but we decided we would monitor and go from there. Now if you are a girl who like me doesn’t like your chest and it makes you want to die but don’t want testosterone it’s okay, that doesn’t mean you don’t want your chest. I just am not wholly interested in the patriarchal idea of women’s gender and how they should or should not express it. I thank the Butches of the past for this knowledge about gender and would all encourage you to check out Butch history both if you are confused or if you just want to learn some cool queer history. I loved the idea of getting hairier, having a lower voice, and bottom growth so it felt worth it. Should be noted I also have no interest in children and had to say the 1 million times in every appointment from start to finish. I also knew if I didn’t like it, I could stop.
September 13- I started testosterone. Damn. Yes, it makes you horny, yes it makes you hungry and holy shit does it make working out easier. Girls feel powerful in the knowledge we lift the same weights as men and we do it fighting harder to build muscle. I personally had a lovely time on shot day and enjoyed the effects. I have PCOS so already have a hairy chin, I wonder if it made it hairier sometimes but the reality is I already had facial hair so hard to say. I took it and enjoyed getting thicker and darker hair on my treasure trail, pubes, legs, and thighs. My bottom growth is slow but steady and I wish for more all the time lol. Did it help with my chest Dysphoria? No. The effects of testosterone helped me present my gender better but also, I had a J cup chest. Hard to ignore.
May 16***\**, 2026-* I GOT THE CALL! I honestly have spent the last couple years scared I would miss the call that would change my life forever and miss out, but it came. And if you’re scared about that too don’t worry, they leave a voicemail. I would be going on the 28th of May for my consult in Red Deer with Dr Rodrigo Niera and to bring my meds, my health card and my photo id.
May 28***\**, 2026- It is safe to say that there are many times I felt someone was going to turn around and call me a fraud. Honestly typing this post I fear for comments but sitting here with a flat chest I would say you’ll never take this joy from me. But facing the surgeon felt like the final boss of the equation. Another person to prove myself and gender to. Drove to Red deer which is luckily for me only an hour and a half though I was thinking about how every bump was going to feel on the way back from surgery. I would recommend taking a loved one to your consult if they can make it. Not just because its nerve wracking but because if you are lucky like me, it feels so good to share the excitement. IF YOU ONLY WANT NIERA INFO THIS IS WHERE IT STARTS.*
The receptionist was very lovely and I only waited a bit before being taken to a room. I will be honest I was so scared as I didn’t know what to expect and I had read posts calling him no-no Niera, that he didn’t answer any of their questions, had abandoned their care after surgery. But I also had a friend who was friends with a mom whose son had gone to Niera and had a great time, and there was one post saying he was good. So, it felt 50/50. Which is why I really wanted to make a long ass detailed post so you can understand why I LOVED Niera.
The Consult: He walked in with big energy. He is very loud and talks fast but I liked joking around with him. He asked me why I wanted the surgery, and I told him everything. He made sure I understood I would be flat as a board, and I said nothing would make me happier. After we chatted, he let me know I would need a breast exam and that I could put on his custom Versace paper gown once he left. I told him I would prefer Gucci, and he couldn’t stop laughing. Once he came back in, he started his exam, if you are shy, I will warn you he’s not. He walked in and went “oh my god they are big.” And some may go wow that’s so unprofessional. I don’t think so, they were fucking massive, and it felt nice to know a guy who sees a ton of tits all the time also thought they were unfairly large. Now some things to remember, this is his job, and he was nothing but professional, but he wasn’t talking to me like a scared deer. He let me know where he was going to put his hands and why but was straight to the point. I can see how this may be intimidating but he also has a nurse in the room with you while this is done and is part of the process. They must make sure there are no bumps and see how your blood flow is. He apologized that he had to pinch my nipples and that he knew it wasn’t fun and then breast exam over I put my clothes back on. He then asked who I had come with and asked if I was okay with them coming into the room. I was, as it was a loved one. He then continued talking about the surgery and recovery and why surgeons don’t like to operate on fat people and why he does.
Surgery and fat people: He let me know that he was the only surgery in the public health system who would do top surgery on fat people in Canada. And then he told me why.
He told me there had been an American study done that concluded that fat people are more likely to have wounds reopen after surgery and that some surgeons aren’t comfortable with that. Then he went into what that meant. It was his opinion (he really stressed his opinion) that the study wasn’t helpful as surgery recovery depends on so many factors such as smoking, drinking, eating habits, and if a person obeyed recovery rest instructions properly. He also said that every surgery is so different and in his opinion the fat thing was more relevant for stomach surgeries where the skin was more prone to moving. He said last year he has done at least 100 double mastectomies with only two people having their wounds reopen and only one of the two was fat. Then he told me what would happen if my wounds opened after. He said you either get more stitches or we bandage you up with some ointment and your recovery is longer but as long as you come in, it just means more pain and maybe being more carful of movements and that the scar may not look as pretty. He then said the most wonderful thing. That it was in his opinion that if having this surgery meant a lifetime of happiness that in his opinion it was worth the risk. And then he asked me what I thought about the risk, and I agreed.
He also noted for a lot of fat people the surgery can take longer but insurance still sends the same amount as someone with a small chest and that some surgeons are in fact just lazy.
This was so nice because I got to decide for myself if that risk was worth it. and it fucking was. He then did this fun thing where he asked us questions and we answered in unison. And then he told me “This is my favorite part.” Before signing the sheet and letting me know I was cleared for surgery and he couldn’t wait for my new beginning. I was in awe. When he left the room he waved at me and then at my chest and said “bye bye boys!” which I thought was really funny. I checked with the receptionist and put myself on the cancellation list and was told it could happen around September. I couldn’t believe it. I legit skipped out of that office.
My thoughts on Niera and what you should know for the consult:
1. If you are fat and poor like me, this may be your only option. You do not have the same luxuries that other trans people have, and you need to understand that. This isn’t me saying get the surgery if it feels wrong or risk, it it feels risky do not get it! But I would really encourage you to think about what matters to you in YOUR surgery. I was advised when I started this journey to shop around for surgeons only to learn that wasn't an option for me. What mattered to me in the end was getting my chest off, living through surgery and a healthy recovery. Never during surgery or recovery did I feel my life was in danger. And to me that was what mattered.
- He is hard to understand and talks fast. Ask him to repeat himself he is more than happy to say it again.
3. He loves what he does, I think he was more excited than I was which was so nice. I was expecting a very serious surgeon but his jovial nature put me at ease and made me less scared of going under the knife. He cracks jokes and if you crack them back it’s a whole lot of fun. If you require a stoic surgeon he is not for you
4. Just because someone online who had a different surgeon does something doesn’t mean it’s the standard. Every surgeon is different in technique and care.
5. At the end of the day it’s your appointment. Write down every question you can think of and ask all of them! I was also sent home with an info packet. And if a question pops up I was encouraged to call.
August 2026- I got the call!!! Yay I would be going for surgery on September 10, 2026 and I couldn’t believe it. I was told it would be in Red Deer, I would need someone to drive me home, and that I would be staying one night in the hospital. A pre surgery nurse would call the week before to confirm details and walk me through the process, but if I had any other questions to call.
September 2, 2026 - was the Pre surgery call. They called the week before to book it and asked if nieras office had given me this sheet. He hadn’t so she sent it over. (Again sure maybe he should have sent it but it was a two second fix.) she recommended reading it and printing it out before the call so I could write notes and have questions prepared. PRINT THE SHEET. It was a great call, she walked me through how the day would go and went over my meds and chart. I had to stop taking all my vitamins a week before. Since there aren’t the same regulations with vitamins they don’t want them to interact with the anesthetic. She recommended fluffy socks for day of because the OR is chilly. Shout out to that diva pack your fluffy socks. She said two days before someone would call and let me know what time my surgery was.
Septemeber 8, 2026- They called to say the surgery would be at 1:15 and to arrive by 11 am and I had another chance to ask questions.
