Transgender Teen Survival Guide

Lee says:

You should still be able to do both, yes.

Binding should still be possible, although it may be painful to have pressure on healing wounds.

When it comes to top surgery, it might make things a little harder for the surgeon, and in rare cases, it might impact what type of top surgery procedure you’re eligible for depending on much scar tissue there is, how deep the scarring goes, where the scars are, and if they impact blood flow. That’s something you’d have to discuss with your surgeon at your consultation.

I don’t think it would typically put your top surgery in jeopardy from a purely surgical perspective, although it might impact the aesthetics and also make it harder to access the surgery in the first place.

But if it is extensive deep scarring you should discuss it with your top surgeon when you have your consultation to get their assessment- we aren’t medical professionals, so it’s best to consult with them about your particular situation, and I can’t guarantee that surgeons won’t turn you down.

Personally, I spent a lot of time thinking about all the effort I’d spend on taking care of the top surgery incision scars, and researching scar gel and silicone scar strips, and all that kind of helped me put my perspective into the long-term. 

I knew if I’d bother with scar care for my top surgery scars, and I wanted a good aesthetic outcome from my top surgery, I wouldn’t want to have even more scars with a negative history behind them as permanent reminders on my past on my new body.

I wanted top surgery to be a fresh start in a body I’m comfortable with, so I didn’t want to let my chest dysphoria in the moment jeopardize how I’d feel about taking off my shirt in the future because I didn’t want to go through all the trouble of getting top surgery to be self-conscious.

So that was my motivation in helping to stop self-harming in the areas I had been doing it (which all turned out to be potential phalloplasty donor sites so even more of a motivation to stop so I wouldn’t end up with a scarred penis), and not start doing it on my chest.

If you’ve already got scars there, don’t think “Oh guess it’s too late, I might as well keep going!” because that isn’t the case. Instead, you should start scar care (the Post-top surgery scar care link has tips that apply to any scar) and remember the reasons why you don’t want to continue.

One good reason to stop: Even if it’s medically possible to get top surgery, you may find that self-harm will delay your surgery anyway because you usually need a letter from a therapist/mental health professional saying you’re mentally stable and capable enough to get surgery.

If you’re currently self-harming, they will usually want you to wait to get surgery until you’re not doing risky self-injurious things so it’s best to try to wean yourself off from self-harming if at all possible so you’ll be able to sail through that process without having to wait even longer which isn’t great for the mental health either. And I’m saying this from personal experience as someone who had my top surgery letter delayed as a result of my mental health.

Shifting your mental attitude from “this is fine” to “actually, this is a potential barrier to me getting top surgery as soon as possible and so I need to do whatever I can to work on this” can make a big difference because I’m not always motivated by taking care of myself, but I am motivated by doing whatever it takes to transition.

So if you are still self-harming, you should try to stop doing so, both for your general health and to ensure a smooth top surgery process. Here is a post with suicide hotlines and mental health services, and I encourage you to reach out if you need help.

Figure out what your triggers are, unfollow blogs on Tumblr that post about self harm, throw away any “tools” that you use to hurt yourself, hang out in public places like parks (it’s harder to hurt yourself in public than when you’re alone), follow “recovery” blogs on tumblr, or work on a skin care routine (put energy into helping your body instead of hurting it).

When you feel like hurting yourself, try these things: Draw on your body where you want to hurt yourself, rub ice on your body where you want to hurt yourself, do the same thing you want to do to yourself to an object (if you want to cut yourself, cut paper up), do one of the above distracting activities, scream into a pillow (it sounds silly but it can really help), take a cold bath or shower, snap rubber bands on your wrist (harm reduction), or listen to loud music. 

I also find exercise like running or doing push-ups helpful because it’s something physical, it releases endorphins and helps mental health, it’s distracting, and it can help you feel masculine. And then after I exercise, I try to do something that’s self-care like watching a show I like, or doing something to try to cope with dysphoria like packing.

You should also look into Getting a therapist and being in therapy, and you may also want to look into medication too- both of those things at the same time are generally more effective than one or the other. You’re clearly in pain, and you deserve to get help.

Lee says:

If you have a minor scarring on your donor site, you could still use it as a donor site but the scar will be transferred to your penis so that may be an aesthetic but not medical issue. This is true for some self-harm scars- there’s a post about that here. 

But if there’s more extensive and deep scarring there may be a medical issue with using that donor site, you may want to choose another donor site like ALT (thigh) instead of using your forearm.

As @gendercube​ wrote:

“Whether or not the donor site can be used would depend on how much scarring there is, how deep the scars are, where the scars are, and what impact the scarring might have on your recovery. Extensive or deep scarring could impact blood flow, for example, and might make using that donor site more risky. This could mean either having to use a different donor site or delaying parts of your phalloplasty for a later time. A friend of mine had scarring on his wrist from a childhood surgery that made it risky to do his glansplasty right away, so he delayed it and had his glans done 2 weeks post-op. This allowed the phallus time to heal and establish strong blood flow before adding another element of healing onto it. Less extensive or shallow scaring usually has no effect on the donor site.”

More info on lower surgery is in the Bottom surgery (genital surgery) page!