Last month, Carl*, a 33-year-old banker in New York City, decided he was going to make a big change that he had been stewing about for years: He was going to get breast reduction surgery. Carl recalls hearing jokes about his body — specifically his chest — all throughout his adolescent and teenage years, and says the words stuck with him.
After seeing a subway ad for male breast reduction surgery, Carl was intrigued, but still felt embarrassed about getting plastic surgery on his breasts. So, he hid it from everyone he knew, except for the friend who picked him up after surgery. As a private person, Carl didn't feel like anyone needed to know what he was choosing to have done. "It was strictly personal for me, and was just about me bettering myself and making me happy with how I look," Carl says. Now that he's had the operation, he says it has improved his confidence immensely: "Now I'm walking with my chest out, so I love it."
There's actually a medical cause for enlarged breasts in men.
All men have breast tissue, but some have slightly more for a variety of reasons. The medical term for enlarged male breasts is "gynecomastia," and it affects around 50-60% of adolescents, according to a 2009 study. Gynecomastia isn't dangerous, and there have been no studies that show men with it have a higher incidence of other diseases or breast cancer, according to Dr. Steinbrech. But many people choose to have surgery for cosmetic reasons, he says.
Generally, gynecomastia is caused by a "slightly different balance of testosterone and estrogen," Dr. Steinbrech says. Taking certain medications (like anti-androgens, antidepressants, and certain chemotherapy drugs) or drugs (like marijuana, amphetamines, and heroin) can cause gynecomastia, according to the Mayo Clinic. Another common cause of gynecomastia is using steroids, Dr. Steinbrech says. "In bodybuilders who have done a round of steroids, it throws off their balance of hormones, and they subsequently get a rebound production of breast tissue right underneath their nipples," he says. As it turns out, Dr. Steinbrech says that many of his patients are "ripped Instagram fitness guys." But not everyone who gets gynecomastia treatment does it for the same reason.
Male breast reduction is becoming increasingly common.
Male breast reduction surgery is becoming quite popular, particularly with men in their 20s and 30s, according to Dr. Steinbrech. In 2016, an estimated 27,760 gynecomastia procedures were performed, which is a 36% increase since 2010, according to the American Society of Plastic Surgeons. Most of the patients Dr. Steinbrech has treated for gynecomastia say they're embarrassed by the amount of breast tissue they have. "They won't take their shirt off at the pool, they don't like to get dressed in the locker room, or they're embarrassed about having sex with the lights on," he says. Dr. Steinbrech suspects that one driving force behind the popularity of gynecomastia treatment is that more men are interested in showing off their bodies on social media. "There's no stigma about showing off how good you look or how ripped you are," he says.
Unfortunately, men who seek breast reduction surgery still face stigma.
Interestingly, there has been a lot of research on the psychological effects of gynecomastia in young boys. Because visible breasts are typically thought of as a "female trait," some researchers believe that having gynecomastia can result in feelings of "spoiled identity" in some men. A 2009 study actually compared the shame and stigma associated with gynecomastia to the objectification of women's bodies, because having visible breasts can "marginalize and subordinate" men within gender hierarchies.
And while cisgender men who seek out gynecomastia surgery don't face the same discrimination that transgender individuals face, parallels can be drawn between the two experiences. With gynecomastia surgery, many cisgender men are compelled to have it in order to feel like their body is more in line with their gender identity. Transgender people who have gender dysphoria, on the other hand, might experience feelings of intense distress that their body isn't consistent with their gender identity. (To be clear, we're not equating the two experiences; we're simply highlighting the fact that, in both these instances, a surgical procedure can relieve the distress.)
The reason why Carl waffled on the idea of surgery for so long — and then didn't tell anyone he was having it — was mostly because he didn't know any other cisgender men who were getting plastic surgery. But he also felt weird about talking about "breasts" themselves. "I was kind of embarrassed talking about it, because I don't really like that term when used for a male," he says. Learning that there were surgeons who specialize in this kind of plastic surgery made him feel secure in his decision. "You can tell that the wall is starting to chip away, because they even have facilities geared towards men," Carl says
Ultimately, gynecomastia surgery can help people find confidence.
Electing to have plastic surgery is a very personal decision and should come without judgement. Unfortunately, people are often shamed for wanting to make the small tweaks that can be emotionally transformational for them, Dr. Steinbrech says. "I really believe that my patients end up being happier — not just because of their body image, but they're happier with how they feel," Dr. Steinbrech says. Indeed, the authors of the aforementioned 2009 study wrote that there needs to be more resources available for people to seek gynecomastia treatment, simply because of the psychological effects it can have on men.
So, will Carl ever come out to his friends and family about his surgery? No, he says. "It's not that I don't feel comfortable, but I wouldn't tell them because it's none of their business," he says. "Maybe if it was during a truth or dare game."
*Name has been changed
Gender and sexual orientation are both highly personal and constantly evolving. So, in honor of Transgender Awareness Week, we're talking about the importance of language and raising the voices of the LGBTQIA community. Welcome to Gender Nation, where gender is defined by the people who live it. Want to learn more? Check out our Gender Nation glossary.