Although this article primarily focuses on transmasculine top surgery, much of this information applies to transfeminine top surgery too.
Depending on your circumstances, you may be able to get top surgery as young as age 16.
By age 18, most people can make their own medical decisions, including whether to get top surgery or other gender affirming procedures.
In some U.S. states, the age of majority — when you’re legally considered an adult — occurs between 18 and 21.
Children and adolescents who have not reached their state’s age of majority need a parent’s or guardian’s permission to pursue top surgery.
Your access to affirming medical care, whether you have insurance and whether your plan will cover it, and your ability to pay the overall cost will also affect when you’re able to get top surgery.
Yes, it’s possible to be too young for top surgery.
Many surgeons will not perform top surgery on adolescents under age 16. Additionally, many insurance providers do not cover top surgery or other gender affirming surgeries for adolescents under age 16.
Potential surgeons and insurers alike want to ensure that prospective patients are able to make a fully informed decision and can consent to care. That’s why the age of legal majority is typically considered the baseline.
But it’s not impossible to receive care as a minor. If you have a supportive parent or legal guardian, you may be able to get top surgery with their permission.
According to an October 2022 report from Reuters, at least 282 adolescents ages 13 to 17 received a gender affirming mastectomy in 2021 and filed an insurance claim for the procedure in the United States.
Your state’s legal statutes will ultimately determine whether you’re able to pursue top surgery or other gender affirming surgeries before you reach the age of majority.
As of July 1, 2022, the following states proposed laws that impede or explicitly prohibit minors from receiving gender affirming surgeries:
To learn more about the legislation in your state, check out these interactive maps from the Movement Advancement Project and the Equality Federation.
No, no one is ever too old for top surgery — or any other gender affirming surgery, for that matter. It’s never too late to transition.
Your physical and mental health usually have a greater impact on your eligibility for surgery and overall recovery process than your age.
Your clinician will take note of the following during an initial consultation:
- whether you have any underlying health conditions and what you’re doing to manage them
- what over-the-counter and prescription medications you take, if any
- any previous surgeries and other upcoming medical procedures
Your clinician will use this information to help assess your risk of complications and discuss your options.
You know yourself best. What a parent or guardian thinks, whether a healthcare professional agrees — none of that changes what you know to be true about yourself.
Take all the time you need to explore what feels right for you. Obtaining parental consent, finding a reputable surgeon, applying for financial assistance, and all other aspects of care are secondary to your comfort and confidence in your decision.
If you haven’t already, you may find it helpful to start a private note on your phone or keep a journal as you work through your feelings.
Here are some prompts to get you started:
- In an ideal world, what would my chest look like? What about the rest of my body?
- Do I wish, more often than not, that my chest looked different?
- Is chest binding a neutral, helpful, or harmful experience at this point in time?
- How might top surgery help reduce or alleviate negative feelings or feelings of dysphoria?
- Would top surgery make my life easier or better overall?
- Am I able to take time off of school, work, and other obligations while I recover?
- Who can I call on to help support me during recovery?
Most healthcare professionals and insurance providers require a thorough assessment before authorizing top surgery and other gender affirming procedures.
This typically includes at least one letter of recommendation from a doctor or other healthcare professional, such as a psychiatrist or therapist, and a well-documented record of consistent gender dysphoria.
Although gender dysphoria is not a mental health condition, many clinicians look to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) for guidance.
The DSM-5-TR defines gender dysphoria as “a marked incongruence between one’s experienced/expressed gender and their assigned gender, lasting at least 6 months.”
The included diagnostic criteria focus on whether you’re in distress and how severe that distress is — permitting individual clinicians to decide whether you feel “enough” incongruence to necessitate affirming medical care.
To help prevent this, many medical institutions also consider the World Professional Association for Transgender Health standards of care or the informed consent model of care.
Yes, your age can influence your overall recovery and results.
If you were assigned female at birth and have not undergone puberty, your clinician may advise you to wait for top surgery. Chest tissue may continue to grow until the end of puberty.
Adults ages 65 or older may have a longer recovery period.
Your skin loses elasticity and collagen as you age. Collagen is essential for cellular development and tissue regeneration, and elasticity allows the tissues to recover. This decrease not only hinders healing time but also
Smoking cigarettes or vaping nicotine can also affect the healing process.
Your clinician will be able to give you an idea of what you can expect based on your specific health profile.
It’s important to be as transparent as possible with your clinician about your desired physique. Save photos of what you do and don’t like about others’ chests and bring them to your consultation.
Talking with people who have already been through the process can also help manage expectations.
Remember, there’s no “right” or “wrong” age for top surgery — there are just different factors to navigate at different stages of life.
To learn more about what top surgery entails, read our comprehensive guide.
You might also check out the following articles:
- “5 Things to Know Before Getting Top Surgery” by Max Rigano for GoodRx
- “Top Surgery 101: Procedures, Cost, and Safety” by Mud Howard for Folx Health
- “So, You Want Top Surgery. What’s Next? A guide for choosing a surgeon, preparing for surgery, and recovery” from Fenway Health
To learn more about costs and financing, check out:
- “Financing & Support for Gender Confirmation Surgery” by Laura Dorwart for MoneyGeek
- “How Much Does Top Surgery Cost FTM in The United States” by Pedro Santos for ENBYNYC
- “Top Surgery Grants & Financing” from TopSurgery.net
QueerDoc has a hub with information about scholarships, surgeons, and more.
Soren Hodshire (he/him/his) is a queer trans writer based in Chicago, Illinois. After getting his Bachelor of Arts in cultural studies and minoring in women, gender, and sexuality studies, Soren has been organizing, writing, fundraising, and facilitating for queer and trans organizations. He’s deeply committed to community building and solidarity across marginalized groups. When Soren isn’t writing or watching video essays, you’ll find him listening to a podcast. You can follow him on Twitter (as long as it still exists) and Instagram.