My experience seeking ‘top surgery’ in Nashville

For the first 10 years of my life, I feared puberty; I had nightmares about growing breasts and becoming a woman, oftentimes waking up just to cry real tears over the inexorable reality of my situation. Back then I didn't have terms like gender dysphoria or transgender to understand what it was I was going through. It was more than a struggle with growing up, and when I did eventually go through puberty as a female, I wanted nothing more than to die.

For nearly 5 years, I binded my chest to make it look flatter. I semi-permanently altered my posture by hunching my shoulders and back so my shirt wouldn't touch my chest. Today though, two weeks post-op from having peri-areolar top surgery, I celebrate a new lease on life, presenting more as the man I am.

Coming from a smaller Tennessee town, the process of finding a surgeon who would perform this surgery (and having it not cost an arm and a leg) proved tough. I had no clue where to go—all of the famous top surgeons were in Florida or Pennsylvania. My initial thought was to see plastic surgeons at clinics who, while they may not have much experience with transgender clients, had the technical skills to do what I wanted.

So I made appointments with Nashville plastic surgeons with ritzy clinics that specialized in things like mommy makeovers. Bad move. At one awful appointment, after having explained I had been socially transitioned for 5 years and medically for 1, a surgeon asked me if I was sure I had finished puberty yet. That was after their nurse stopped me at the front door, saying I needed a parent with me for my appointment. In most situations I would have been flattered to be seen as young but unfortunately being treated like I was twelve made the entire experience very unpleasant. It ended with the surgeon telling me I needed to consult my doctor about whether or not I was physically ready for this surgery—specifically whether my breasts were done growing or not.

After that I stopped going to see those kinds of plastic surgeons and was referred to Vanderbilt. From there, things went much better. At my first appointment, everyone made sure to use my preferred name and pronouns, while also going out of their way to make sure I was comfortable. My new surgeon, Dr. Al Kassis, knew exactly what kind of surgery I was talking about when I told him what I wanted and was great about making me understand his process. I left feeling extremely happy and excited by the prospect of finally being one step closer in the process.

I waited a few months for my insurance to be processed, get my pre-op appointment and for my surgery date to be finalized. On the day of my surgery, they were able to start over an hour earlier than expected. All of my nurses and doctors were friendly and professional; both of my nurses assured me I was in great hands and that they knew I would be thrilled by Dr. Al Kassis's work when it was over.

Upon first seeing my bare chest immediately after surgery, I wasn’t so sure. I was on a lot of drugs and very disoriented. It was not until a few weeks later, at my post-op appointment, that I actually got a clear idea of what I now looked like. And boy, I was fucking thrilled.

Lee Hatcher immediately after top surgery

Yes I was bruised and swollen, but I was also no longer mentally fighting what I saw in the mirror. I will have virtually no scarring thanks to Dr. Al Kassis and can be more confident in my everyday life.

When asked about his practice he said:

At Vanderbilt University Medical Center, we are committed to providing gender-affirming care, including a comprehensive range of surgical options. We deeply understand that transgender people have historically had limited access to care, and we have made significant investments to increase access for patients in Tennessee and throughout the Southeast. While gender-affirming procedures can be life-saving, we also know care given by our staff can set patients up for positive, long-term health outcomes. We have a standard of care that prioritizes communication, dignity, and the well-being of our patients.

I feel honored to work with an outstanding team focused on a comprehensive approach to patient care. Our patients report positive impacts on the mental, emotional, physical, and overall quality of life following gender-affirming procedures.

While we take great pride in the work we are doing today, we are already looking to increase the scope of our services over time. Vanderbilt seeks to advance health equity for transgender patients with world-class coordinated care, innovative research, and critical education for future generations of providers.

At my last appointment with him, after thanking him profusely for what he had done for me, he thanked me and asked me to share his work with others. A lot of people in the South have no clue where to start with this kind of process—I know I was clueless. It’s difficult and I hope that by sharing my story, it will give the community more knowledge and resources within Tennessee.

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