A trans man describes the impact of having top surgery: ‘I didn’t realise I could even be this happy’
A trans man says that he did not realise how happy he could possibly be until he had top surgery towards the end of last year.
Casper Walker underwent the gender affirming chest surgery in November, and has never looked back since.
It took around three years from Mr Walker’s first appointment at his gender identity clinic before he went under the knife, and although it proved to be well worth it he found that the process of getting on a waiting list and arranging the operation was far from straightforward.
“You actually have to ask to be on the waiting list for top surgery, but they don’t tell you that,” he explained.
“I had my review on May 18, 2023, and they spoke to me about how being on testosterone was going and whether I had plans for surgery. I said I couldn’t wait to have top and bottom surgery, and they insinuated that I was going on the list – so I just presumed that meant I was on.
“As it turned out, that wasn’t the case. I called up and checked to be told I wasn’t on the list. It felt like a big blow when I was back to square one, and I really struggled with my mental health during that time.
“It’s kind of like if you sprained your ankle, you would have to ask for a bandage and ibuprofen. No other procedure or surgery would work that way.
“Even when you do tell them, it’s still a big process. There’s a lot of talking to different people, them talking to each other, forms to fill out and assessments – lots of hoops to jump through.”
After telling his clinic that he wanted to push ahead with top surgery, Mr Walker met with a psychoanalyst who produced a wellbeing summary report confirming that he was of sound mind, and understood that it was a permanent change.
However, no surgeon performs top surgery in Scotland, so he had to travel to England for the operation. Thankfully, there is a patient travel service in Aberdeen who took care of arranging transport and accommodation.
Mr Walker had done plenty of research going into the procedure, but one thing that did surprise him was that he was able to decide on the shape of his incisions, and the size of his nipple grafts – with his doctor saying he was the only guy that had come in without a reference photo.
That did not bother him though, and once the surgery was complete, he felt a positive impact almost immediately.
“The nurse told me afterwards that the first thing I said when I wasn’t even fully awake yet was just ‘are they gone’, and then I drifted back off to sleep,” Mr Walker recalled.
“When I was fully conscious, the first thing I did was look down. There is so much padding and dressing, so the second thing I said was still ‘are they gone’.
“My husband was with me and said yes. It’s hard to explain, but it’s like I stepped into my own skin at that point, I became the real me for a change. It was immediate relief.”
Mr Walker only spent two nights in hospital – one more than the standard due to a reaction to anti-sickness medication – but even in the months since returning home he has found it hard to believe exactly how positive the impact of going through the procedure has been.
“I think it didn’t quite fully sink in until the first time I went swimming,” he said.
“I was there for about half an hour and then I looked down and realised I had no shirt on. I went red and started giggling like a little kid, I was so happy because I was shirtless at the pool and allowed to be.
“It’s crazy. I feel like I can’t keep up with my own happiness. I didn’t realise that I could even be this happy. I knew that it was going to make a huge difference, I just didn’t realise how big and how quickly that would that happen.
“The first time I met up with my dad, which was about a week after I got home and I wanted to give myself some time, I literally just stepped into the door and my dad said ‘wow look at you, you have a happy aura around you’. He thought I seemed genuinely happy for a change.”
As a result of getting top surgery, Mr Walker is now thinking about the future in a way that never really seemed possible before.
He has taken up hiking, and is generally just less self-conscious walking around in day-to-day life.
However, he knows that there are some myths that occasionally surface about the process and impact of gender affirming surgery, and his experience could not be further from some of the claims that are made.
“Not only does it not happen as quickly as people think, but a lot of people don’t realise that most if not all trans people have known that they are trans since they were pre-puberty,” he stressed.
“I did a bit of psychology in college, and we learned that by the age of eight children are aware of whether they’re a girl or a boy, and will be adamant on people misgendering them. I found that quite interesting, because it’s a lot younger than even I thought.
“Most, if not all, trans people have been waiting for a really long time by the time they get to this stage. It’s not just three to 10 years on the waiting list, it’s long before that as well.
“Nobody is turning people trans, or convincing people to be trans, because even when you are trans you have to be proactive about it, and know exactly what you’re talking about.
“At every stage of your transition, you have to have a talk with at least one therapist to make sure that you want to go forward with whatever that next step is – whether it’s surgery, or hormone changes.
“It’s not as simple as telling the GP that you’re trans, then everything starts like it’s Christmas. You get an intervention at every single stage.
“I understand that they need to make sure people know what they want, but it’s very invasive and lengthy. They definitely made sure.”
