Trans comedian Noah Boutilier opens up about having top surgery: ‘I needed to remove them in order to live’

Transgender comedian and activist Noah Boutilier wants to normalize chest scars that are left on the body after having top surgery, a gender-affirming breast-removal procedure, in the best way he knows how: through art.

The I Am Jazz costar, 29, opened up about his new venture in an Instagram video posted in September, in which he showcased a series of paintings displaying various representations of top-surgery scars. Each aims to reflect one of the countless iterations of marks left on the chest after having surgery.

For Boutilier, the project, which helps to fund his own medical journey, stems from a very personal place.

Two years ago, during his first consultation for top surgery, Boutilier's doctor told him to expect a giant scar that extended “all the way across” his chest, simply because of the way his chest was naturally shaped. The news came as a shock.

“I was excited that I was going to be having top surgery [but] it was still shocking to me, because I had not seen a lot of people with a scar all the way across their chest,” he tells Yahoo Life, noting that top-surgery scars vary from person-to-person, depending on the amount of skin tissue that’s required to be removed.

As he started to heal, however, Boutilier says he grew to like his scar. Eventually, he learned to love it, simply because it was “so different from other people’s.” That’s ultimately what inspired him to begin the art project, as a way to empower others and to remind them that "their scars are their own to love," he says.

“It’s like a snowflake, everybody comes out a little bit differently, and we need to embrace that instead of all trying to conform to one idea,” he explains. “You go to some surgeon’s offices and they have these pictures hanging on their wall of, like, the ‘perfect chest,’ but that's not a standard that a lot of people can reach.”

Furthermore, upon doing research, he noticed a serious erasure of Black trans men in the media when it comes to top surgery, which is why, in his paintings, he intentionally paints the scars and nipple areas of Black trans men with gold paint, ”to make it look more important.”

Gender-affirming surgeries, in particular, have been a heavy topic of discussion in recent months, following the passage of laws in Arizona and Alabama that made it illegal for doctors to perform such surgeries on transgender patients under 18.

While most of the studies on top-surgery focuses on adults, and have found quality-of-life benefits, a very small study published by JAMA Pediatrics in September found that top surgery is "associated with significant improvement in chest dysphoria, gender congruence, and body image in transmasculine and nonbinary teens and young adults." A prior 2021 study, also small, published by the American Academy of Pediatrics, observed that "chest dysphoria is a major source of distress and can be functionally disabling to transmasculine youth."

There are no official statistics on how many minors receive top surgeries each year in the United States, though 11 U.S. clinics reported to have administered a total of 203 procedures on minors in 2021, notes a recent New York Times piece highlighting the work of Dr. Sidhbh Gallagher, a Florida-based surgeon in the field (who also happens to be Boutilier’s sister in law).

Boutilier says he wants to use his own story of having dealt with gender dysphoria from an early age to bring awareness to trans youth and their parents — not to encourage them to have surgery, but to educate them about knowing all the facts before making assumptions.

That process is a slow burn, he admits, and one that starts with "unlearning the cultural biases" we’ve placed around sex, gender and beauty standards.

“I just find it ironic that our society will tell us a woman who has cancer, ‘Go ahead and get [your breasts] removed. You're so beautiful even if you don't have breasts. You're valid, you're perfect the way you are. It's better to be healthy than to be beautiful,’” he says, arguing that it was a matter of life or death for him to have the surgery. “With my top surgery, the breasts were like a mild form of cancer. I was not going to live a full life had I still had these things on my chest. So, in my way, I needed to remove them in order to live."

"You can see the rate of suicides and trans people and nonbinary people, this is something that affects our whole livelihood," he adds.

According to a 2020 peer-reviewed study by the Trevor Project, an LGBTQ suicide prevention organization, published in the Journal of Adolescent Health, trans and nonbinary youth were 2 to 2.5 times as likely to seriously consider suicide and attempt suicide compared to their cisgender lesbian, gay, bisexual and queer peers.

“The biggest trick to unlearning [systemic bias against trans people] is remembering that it has been learned,” Boutilier says. “There are people of different generations that are going to find it tougher to, so to speak, get along with the newer generations. They feel, oh, this wasn't around when I was there. But it's about unlearning and about showing proof of [trans people’s] existence."

"Each person that you're seeing on the news, give them a name of somebody in your family," he advises. "Make it personal. I think that's how we can move forward."

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