- CJ, non-binary patient in the UK [8]. 2. Dr. Scott Mosser is a surgeon in San Francisco who specializes in gender affirming Top Surgery and Body Contouring procedures. In this case, the therapist writing the required letter of medical necessity should understand how to write the letter to satisfy insurance requirements, for example using he/him pronouns. How will you, or did you, pay for your Top Surgery? What is "Nonbinary" and What Do I Need to Know? A Primer for Surgeons Providing Chest Surgery for Transgender Patients. A Comparison of Gender-Affirming Chest Surgery in Nonbinary Versus Transmasculine Patients. From his pre-operative assessment to the post-operative treatement regimen, this method of care is truly The Garramone Method. Also, society has become more understanding of the differences of gender identities, which allows many people who identify as Non-Binary (nonbinary) to be able to live their lives with this identity. Dr. Mosser was able to achieve the following changes in his EMR systems [9]: Having worked extensively with non-binary patients, Dr. Mosser is well-versed in the techniques that can achieve the outcomes that non-binary patients often desire. Increasingly more nonbinary patients are obtaining better access for gender-affirming chest surgery (top surgery), representing an important subset of patients who undergo such surgery. My breasts are beautiful. In one study, 77.2% of non-binary participants indicated that they had some interest in using hormones or surgery to alleviate gender dysphoria, while 17.7% expressed no interest, and 6.3% indicated that they had already completed all medical transition interventions that they would like.[3]. Top surgery can include both breast augmentation or chest masculinization. He is considered the World’s Leading Authority on FTM Top Surgery. 1. A post shared by Nats Getty Gorgeous (@natsgetty) Having performed thousands of successful FTM Top Surgeries or Non-Binary (nonbinary) Top Surgeries, The Garramone Method is a time tested and reliable set of treatment protocols for FTM Top Surgery. 3. GenSculpt® is the new standard of care when having FTM Top Surgery and Dr. Garramone is the creator and the only Plastic Surgeon offering this method. Based in San Francisco, Dr. Mosser sees patients from around the country. He has specific drawings and marking for each individual chest, and a systematic set of measurements he performs with each and every surgery. Top surgery is a phrase used in the transgender community to mean a variety of kinds of gender-validating surgeries that can be done on the chest or breasts. In a healthcare setting, non-binary people often feel misunderstood and face pressure by healthcare providers to "transition fully"[4], to conform to binary medical narratives[5], or to transition according to a standard formula: "The standard formula is you get on hormone replacement, and then you get top surgery, and then you get bottom surgery. Non-Binary Surgery Overview This content is going to cover the fundamentals of gender identity and the surgical techniques that Dr. Mosser has used with FTN (female to non-binary) identifying patients. Lykens et al. Call and setup a telephone consultation to discuss GenSculpt® with Dr. Garramone at (954) 752-7842, © 2021 All Content Created By Charles Garramone, D.O. ), Distinction between assigned sex (male, female, intersex) and gender identity (male, female, neutral/non-binary), Distinction between legal name and name the patient uses, Pronouns (he/him, she/her, they/them, ze/hir). All rights reserved. Ideal for small chested men, or those with B-sized chests and good skin elasticity. A Primer for Surgeons Providing Chest Surgery for Transgender Patients. WPATH Standards of Care [2], Non-binary individuals may want hormones and surgery, hormones but not surgery, surgery but not hormones, or neither hormones or surgery. Non-binary individuals identify as neither exclusively male or female. controlled. This … GIGI Gorgeous' spouse Nats Getty came out as transgender and non-binary after undergoing top surgery. James E. Lykens, MA, Allen J. LeBlanc, PhD, and Walter O. Bockting, PhD, "Healthcare Experiences Among Young Adults Who Identify as Genderqueer or Nonbinary." 2019 Apr 8;39(5):NP106-NP112. Dr. Charles Garramone has been performing Non-Binary (nonbinary) Top Surgery for many years as far back as 2005, even before Non-Binary (nonbinary) was even a common term used by idividuals who identify as Non-Binary (nonbinary) or Gender Variant or Gender Neutral, etc. If the surgeon doesn't use informed consent, then a letter of medical necessity from a qualified mental health professional is required. For example, securing insurance coverage can be difficult. A total of 458 patients with gender dysphoria underwent chest surgery; 58 (13%) patients were nonbinary. GIGI Gorgeous’ spouse Nats Getty came out as transgender and non-binary after undergoing top surgery. Typically, insurance companies want trans patients to follow the standard transition formula that focuses on certain treatments carried out in a specific order, essentially nullifying the existence of those who don't subscribe to that standard. The truth however is that in some cases and with certain insurance companies, you don't need to be on hormones or live as a particular gender to receive coverage for Top Surgery. Hannah Mogul-Adlin. Surgeons who regularly work with non-binary patients have processes in place to help ensure that their practice offers a gender affirming environment for all patients. Different approaches to incision location and shape, and chest contours, plus a number of nipple and areola options are available for those seeking a less binary and more customized Top Surgery result. The good news is that there are ways around the insurance hurdles, and there are surgeons who not only have ample experience with non-binary patients but who have also put practices in place to ensure that non-binary patients feel understood and respected throughout their Top Surgery experience. So the answer isn’t so precise, but it is very apparent that we live in a modern era with an understanding of gender being able to exist in various degrees of male, female, or somewhere in between. Non-binary top surgery is the procedure performed so that your body aligns more closely with your genderqueer identity. McTernan M, Yokoo K, Tong W. Ann Plast Surg. I live in Canada. "Unanticipated: Healthcare Experiences Of Gender Nonbinary Patients and Suggestions For Inclusive Care." And that's the standard idea in the medical field. But non-binary Canadians are … In clear language, this step-by-step guide will help you understand how to: Dr. Scott W. Mosser, MD, FACS Examples of this are inclusive healthcare forms that have non-binary gender and pronoun options, and fields for legal and currently used names; and gender affirming written and verbal communications from the surgeon and their staff. At Larson Plastic Surgery, we don’t believe that any of our patients should fit into neatly marked boxes. Nats Getty Comes Out as Transgender and Non-Binary, Opens Up About Undergoing Top Surgery Nats Getty, who is married to YouTube star Gigi Gorgeous, is … "That was too much for the clinic. From a sociological point of view, there were probably always people who identified as something not male or female. Non-binary, and gender non-conforming individuals may have different surgical goals from the traditional male and female archetypes. Click here for Disclaimer Under Florida Law, Phone: (954) 752-7842 | Fax: (954) 473-2454, Unbound: Transgender Men and the Remaking of Identity, All Content Created By Charles Garramone, D.O. Up until about 2012, most of Dr. Garramone’s patients identified as FTM (femal to male), while only about 20% identified as Non-Binary (nonbinary). What Does Non-Binary Mean? A Comparison of Gender-Affirming Chest Surgery in Nonbinary Versus Transmasculine Patients. You would handle all that in those steps. Ideal for medium to large chested men who prioritize nipple-areola size, positioning, sensation and pigmentation. Persistent, well-documented gender dysphoria; Capacity to make a fully informed decision and to consent for treatment; Age of majority in a given country (if younger, follow the SOC for children and adolescents); If significant medical or mental health concerns are present, they must be reasonably well The WNBA star, who identifies as trans and non-binary… While traditional questions to ask a patient are “Do you identify as female or male?”, this does not completely apply to our current practice. Nats,… The Garramone Method of GenSculpt® FTM Top Surgery: Dr. Garramone has a specific set protocol for all patient when performing GenSculpt® surgeries. By Serena Sonom a November 12, 2020 Male-to-female (MTF) or male-to-nonbinary (MTN) top surgery: This surgery involves using saline or silicone implants to increase chest size … Chest surgery is sought after by many people with different gender variances, so Dr. Garramone created GenSculpt® . Non-binary patients may seek mastectomy and reconstruction of the nipples and areolas to achieve a masculine chest, although some patients desire variations in theses standard techniques to achieve their goals in gender expression. Non-binary folks interested in having Top Surgery may face some hurdles getting to the finish line, but should also know that there are ways around insurance as well as experienced surgeons like Dr. Mosser who are enthusiastic about providing truly inclusive care. Dr. Hazen is an expert in top surgery and has expertise and interest in non binary patients. [7]. Non-binary queer femme, health educator, and intersectional feminist. Insurance plans that include transgender benefits often require the patient to identify as a binary gender. The Guide for Insurance Coverage for FTM Top Surgery In the United States, https://www.mobt3ath.com/uplode/book/book-8601.pdf, https://www.ncbi.nlm.nih.gov/pubmed/29641314. Canada U.K. Australia España France Ελλάδα (Greece) Italia 日本 (Japan) 한국 (Korea) Quebec. Her staff will make you feel safe, respected and cared for. Why are there so many people identifying as Non-Binary (nonbinary)? Chris Godfrey, "How the Healthcare System Screws Over Non-Binary People", Mar 14 2016, broadly.vice.com View this post on Instagram. We now call The Garramone Method of FTM Top Surgery one concise word “GenSculpt® “, which is combined from the words “Gender” and “Sculpting”. is a board certified, award-winning plastic surgeon who is an expert at performing several types of gender affirming Top Surgery and Body Contouring procedures. Top Surgery out-of-pocket can move forward with a surgeon who uses the informed consent model —a Dr. Garramone speaks with over 2,000 new patients a year about having chest surgery and body surgery, so as you can imagine, these people represent a very diverse and comprehensive uniqueness of the Gender Spectrum. Incisions can be longer, higher or lower, or more straight than the typical binary approach to Top Surgery; Chest contours can be less masculine, with more chest tissue left behind; Areola size can be made larger than what is typically done in Top Surgery; Nipples can be left with more projection; Location of the nipple-areola complex (NAC) can be more narrow, and/or higher. Finding a surgeon who is not only comfortable and experienced working with non-binary patients but also knowledgeable about the surgical options for obtaining a less binary Top Surgery result can also be challenging. I lost my left nipple about a week after the surgery. Then GenSculpt® is right for you. History. 6. The WPATH Standards of Care requirements for having Top Surgery are pretty straightforward: Hormone therapy is not a pre-requisite. and were seeking FTM Top Surgery to give you a more masculine contoured chest to help you feel more aligned with your Gender Identity? Of those, 80% were female assigned at birth (FAAB. But that's nonsense because I'd been binding my chest (painfully and dangerously) for a few years, and at the time my chest was my only source of discomfort. The Canadian YouTuber and her designer partner have been married for just one year. There is no clear answer to this question. When seeking Top Surgery as a non-binary person, finding a surgeon with the right experience is an advantage that's hard to put a price tag on. Since 2012 the number of patients identifying as Non-Binary (nonbinary) has steadily increased in Dr. Garramone’s practice and comprises about 40% to 50% of patients seeking Top Surgery. People who identify as non-binary or genderqueer represent a substantial and growing population within the LGBTQ community. Despite this, healthcare practices have been slow to catch up to meet the needs of non-binary people seeking a medical transition/alignment. Despite guidelines to the contrary, transgender people are routinely required to take Testosterone for a year before they can have Top Surgery. "Non-Binary Standards of Care", genderconfirmation.com. Non-binary individuals identify as neither exclusively male or female. What if you were born as a biological female or intersex, and strictly identified as a male and were seeking FTM Top Surgery to give you a male contoured chest as a part of your Gender Confirmation Surgery? Traditionally, the “FTM Top Surgery” designation originated from “Female to Male” chest surgery. It’s a broad introduction, but important to read prior to exploring the technicalities of each procedure type. Edition. What is "Nonbinary" and What Do I Need to Know? Nonbinary gender has to do with who someone knows themself to be. The 2015 US Trans Survey, which included 28,000 participants, revealed that 35% of trans respondents identified as non-binary. 7. U.S. In recent years, some societies have begun to legally recognize non-binary, genderqueer, or third gender identities. They just do not belong on my chest. "I needed top surgery before I knew whether or not hormones were right for me," says CJ. Chest contour, scar placement, scar shape, scar length, nipple-areolar position, nipple size, and areola size are all discussed with patients seeking GenSculpt®. Non-Binary Top Surgery This content covers the fundamentals of gender identity and surgical techniques used with non-binary identifying patients. Non-binary folks who want to use insurance for Top Surgery may face more hurdles. As of 2018, he has completed more than 1,000 Top Surgeries, and due to his gender affirming healthcare model many of his patients are non-binary. (An Osteopathic Physician) www.drgarramone.com 8. © Copyright Trans Media Network, 2011-document.write(new Date().getFullYear());. When it comes to Top Surgery, non-binary folks often face an uphill battle accessing appropriate care. This way you know when you or someone you care about is having FTM Top Surgery and they choose GenSculpt® , they are getting The Garramone Method of FTM Top Surgery. The Canadian YouTuber and her designer partner have been married for just one year. January 2015. https://www.mobt3ath.com/uplode/book/book-8601.pdf Duration: 01 ... Nats Getty Comes Out as Transgender and Non-Binary, Opens Up About Undergoing Top Surgery We receive many inquiries every day asking “Does Dr. Garramone perform top surgery for Non-Binary (nonbinary) patients? There are certain key elements to male chest and breast aesthetics, which help us determine the aesthetics for a non-binary chest. Nats Getty Comes Out as Transgender and Non-Binary, Opens Up About Undergoing Top Surgery. He has been performing this surgery before it was even common for any surgeon to do so. Designer Nats Getty came out as transgender and non-binary in … (An Osteopathic Physician), Click here for Disclaimer Under Florida Law. LGBT Health, Volume 5, Number 3, 2018 https://www.ncbi.nlm.nih.gov/pubmed/29641314  | [FULL PDF] Please visit https://www.genderconfirmation.com/ to become more familiar with The Gender Confirmation Center by Dr. Scott Mosser. Nova Scotia Is Now Covering the Cost of Top Surgery for Non-Binary People Previously, the Canadian province only covered gender-affirming surgery for transgender men and women. Then GenSculpt® is right for you. Feel free to ask me anything about that too! 9. They are getting a reliable, safe, effective, time tested, and reproducible result that cannot be matched by any other method. It's even less clear sometimes what people need if you're non-binary." Top surgery is a viable option for non-binary, gender expansive, and genderqueer people to eliminate or reduce feelings of gender dysphoria or discomfort. Determine if your insurance plan covers Top Surgery, Meet the criteria for medical necessity, Find a surgeon who is in-network with your health insurance, File an appeal if you are denied coverage (appeal letter template included. Clarendon a player for the WNBA’s New York Liberty, shared today that after the surgery they’re “feeling a … “Top Surgery” refers to modification of the chest to either masculinize or feminize this part of the body. What if you were born as a biological female or intersex, and identified as a Female and were seeking FTM Top Surgery to give you a more masculine contoured chest just because you preferred the appearance? Ideal for small chested men with excellent skin elasticity. I looked into trans top surgery (all breast tissue removed) but eventually went with basically a huge breast reduction. It’s the most common procedure performed for transwomen, transmen, and … They are very clear they want you to go down a certain route. 2020 Feb 6. The most commonly performed procedure was the double incision technique with nipple grafts (72%). Tosh would know: They’re non-binary and underwent top surgery. I was told by my doctor that I'd have to go to counseling until I decided to take hormones first, because I couldn't know what I wanted otherwise. They just didn’t know how to express this, or there were no labels for this classification. Layshia Clarendon recently shared that they underwent top surgery. The trans non-binary Women’s National Basketball Association (WNBA) player, who is currently New York Liberty guard, shared on Friday (29 January) that they had had a gender-affirming surgery. This was an observational study of nonbinary patients who underwent "chest-affirming surgery" from 2012 to 2017. There were 111 nonbinary patients and 665 transmasculine patients included in the final analyses. What if you were born as a biological female or intersex, and identified as a Non-Binary (nonbinary), Gender Neutral, Gender Variant, Omnigender, Transmasculine, etc. When Dr. Mosser noticed that his Electronic Medical Records (EMR) system was not set up for his transgender and non-binary patients he demanded changes to make the system more inclusive. US Trans Survey, http://www.ustranssurvey.org/reports Some non-western societies have long recognized transgender people as a third gender, though this may not (or may only recently) include formal legal recognition. It is a chest surgery method and protocol for people born as biological females or intersex, with varying Gender Identity or Gender Dysphoria. Layshia Clarendon is feeling euphoric after undergoing top surgery to remove their breasts. Hormone therapy is not required for Top Surgery. In Canada, every province allows transgender men and women to update their birth certificates without surgery. Esmonde N, Heston A, Jedrzejewski B, Ramly E, Annen A, Guerriero J, Hansen J, Berli J. Aesthet Surg J. Some nonbinary people identify as transgender, while others do not. Ideal for medium to large chested men who wish to retain more sensation in the nipple and areola. )[1] A more recent study shed more light on the number of people who identify as one of the many terms that fall under the non-binary umbrella: In a 2017 survey published by the LGBTQ media advocacy group GLAAD, 12 percent of respondents between 18 and 34 identified with a gender identity other than the one they were assigned at birth. Then GenSculpt® is right for you. This broad introduction will hopefully answer some important questions prior to getting into the specifics of each procedure type. Tatyana Bellamy-Walker, "For nonbinary patients, seeking health care can be a painful task", nbcnews.com Additionally, Getty also posted a video talking about undergoing top surgery. Non-necessary Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Non-Binary Top Surgery. Normally in Ontario, folks can get their top surgery covered, but as a non-binary individual I need a certain type of surgery that is not available in Ontario, which is why I applied in May 2018 to get OHIP to cover non-binary surgery at the Gender Confirmation Centre in California. 4. Requirements put into place by medical professionals to control who gets access to medical transition is called gatekeeping. … In cases where a binary identity is not required, the letter should document specifically how long one has lived as non-binary and used their current name. Any of the above procedures can be customized and combined to help you create the body which best affirms your gender. Nonbinary Gender Affirming Surgery. 5. Many non-binary patients do not choose to go on hormonal therapy, so Top Surgery may be the only medical intervention for their transition. This would classify each person as strictly identifying as a Transgender Person transitioning from Female to Male. Dr. Charles Garramone has been performing Non-Binary (nonbinary) Top Surgery for many years as far back as 2005, even before Non-Binary (nonbinary) was even a common term used by idividuals who identify as Non-Binary (nonbinary) or Gender Variant or Gender Neutral, etc. Colby Sangree, Contributor. Dr. Crane and Dr. DeLeon have several different ways of doing Top Surgery to get a more non-binary result. The Canadian province of Nova Scotia has announced that it will cover the cost of top surgery for non-binary people through its Medical Services Insurance (MSI). The 2015 US Trans Survey, which included 28,000 participants, revealed that 35% of trans respondents identified as non-binary. Hannah Mogul-Adlin. Three percent of those surveyed identified as "agender"; 3 percent as "gender fluid"; 2 percent as "transgender"; 2 percent as "unsure/questioning"; 1 percent as "bigender"; and 1 percent as "genderqueer." This is as opposed to bottom surgery, which is any kind of gender-validating done on the reproductive organs or genitals.As with any kind of transgender people, some nonbinary people seek top surgery, some prefer not to. All of the options are able to be modified to the patient’s personal preferences, and Dr. Garramone will discuss these options with you with great care. Chest surgery for nonbinary patients comprises a considerable proportion of transgender surgery practice, and surgeons who provide affirming care should be familiar with the unique characteristics and treatment options for this population. RELATED: Nats Getty Comes Out as Transgender and Non-Binary, Opens Up About Undergoing Top Surgery "Existing outside of the binary for me is freedom," Clarendon said. A Non-Binary Perspective On Top Surgery. Dr. Garramone performs several hundred FTM Top Surgeries per year and has had thousands of excellent results. - Non-binary patient in the UK [6]. Non-binary people who are paying for Top Surgery out-of-pocket can move forward with a surgeon who uses the informed consent model—a letter of medical necessity isn't required. The Guide for Insurance Coverage for FTM Top Surgery In the United States walks you through the process of getting insurance coverage for Top Surgery and it's important to note that it was authored by a non-binary individual who is not on Testosterone, lives in state that had no legal protections at the time, and had an insurance plan with exclusions—yet they still got their Top Surgery covered! And you know that narrative doesn't apply for every binary trans person.