Non-Binary Person Discusses Having Top Surgery Privately
I Never Leave the House Without a Binder On, Now I'm Raising Money for Top Surgery
Image Source: Xion Ioannou
Xion Ioannou, a non-binary fashion creative, tells POPSUGAR about how their experience in becoming their most authentic self with an underfunded and stretched NHS has led them to seek gender-affirming treatment privately. Ioannou is currently working as an External Business MAA at Urban Outfitters in London after working for eight years in the fashion industry. In their personal life, they are now fundraising for top surgery (bilateral mastectomy) – a life-changing decision for them. Read about their journey, in their own words, below.
When I contacted the NHS three or four years ago to start my transition, I was told that the waitlist for me would be around eight to 10 years; all because I'm non-binary. I'm not classed as a "trans person" in cisgender people's eyes, so people like me are at the back of the list. Transitioning for non-binary people is not taken as seriously as transitioning from female to male, or male to female on the NHS – which I have mixed feelings about – so in the end, I didn't even bother going down that route. I just thought, "you know what, I'll do it myself" and opted to look into it privately.
I'd always been a tomboy growing up. I had my hair cut short when I was around 14-years-old, and early secondary school is where I started experimenting a little bit more with my self-expression. It was quite scary because I felt like I had to be this certain person, and what I felt inside isn't what people are calling you. I always thought that I was a "butch lesbian", because that's what I got told. "'You look this certain way, you've got short hair, you wear these kinds of clothes – you must be a lesbian!'"
I've worn a binder since I was teenager; I don't think I've ever owned a proper bra. I don't leave the house without a binder on. I struggle to breathe because my binder is too tight. I haven't been swimming in about 10 years – I don't even know if I can swim anymore. The last time I went to a beach was probably about four years ago – I wore my binder and a vest in the water – and it was just unbearable.
When I started this journey and came out as nonbinary to everybody at the age of 24, I was like a deer in headlights. I was so lost in trying to even know where to start. But I'm so fortunate to be a present member of the LGBTQ+ community. If it wasn't for them, I would not be in the position that I am in now.
"This man literally has the power to change my life with one word. Do I have to be careful with what I say? Do I 'masc it up' more? Do I lie?"
I put up an Instagram post in June 2022 asking if anyone knows what the hell I'm supposed to be doing to start the process of top surgery, and literally 50 people replied to me to give me advice and the steps that I need to take to start my journey. It led me to finding out that I would need to have a psychological assessment to proceed, and prove that I'm "trans enough" to have top surgery. Because I'm also non-binary, I would need to have two assessments.
I reached out to a few people who were non-binary themselves, because I've heard that there are some doctors who disregard you if you say "non-binary". I found a doctor, and his wait time was eight months, which is better than some who had wait times of 10 months to a year. It was £350 for a half hour session, and when it came to the night before my appointment, it was postponed for another month. I got myself into a downward spiral, thinking it was never going to happen.
When we eventually had our Zoom call, it was a straight, cisgender man deciding if I am "trans enough" in my own body. He really just asked me about my life and when I first knew I was non-binary. I felt like he wasn't really listening to me, it seemed like he was just reading questions off his computer. There was this overwhelming pressure of, "this man literally has the power to change my life with one word". Do I have to be careful with what I say? Do I "masc it up" more? Do I lie?
It was not a half hour call; it was about 15 minutes, and he ended with, "I'll be in touch". After declaring that I was "fine to go ahead with the surgery", it took him another month to send me his approval letter, which meant that I missed the appointment to speak to the surgeon.
I had another online assessment with a transgender psychologist from GenderGP who really saw me. Everything that I was saying, she said, "I believe you." She was really affirming, and it was an amazing experience. "This is your story," she reassured me. Straightaway, she sent me the paperwork, but my original surgeon in Poland said they don't take the referral from that platform, so I was forced to find another psychologist for the second assessment and go through everything again.
Because I'm large, and some surgeons go by size, I was quoted up to £20,000 for the top surgery. A lot of surgeons, including the first one in Poland I was working with, were saying they couldn't operate on me until I "lost some weight" and reached a BMI of 28 – my partner is a size six and very athletic, and her BMI is 28 – so that's not going to happen. I felt really disheartened as I thought I finally got the ball rolling, and then to suddenly be told 'no' because of something you can't change overnight - it was a real kick in the teeth. It triggered so many insecurities about myself, I was essentially told I'm "too fat" to have life-changing surgery. It is one of the worst things you could hear, and validated all negative thoughts I had of myself.
After reaching out to real people in the trans community who had the surgery, it's now booked in, which is a relief. I also read online reviews about the surgeon and the hospital I've chosen, but knowing people in real life with that honest experience is the most important thing for me. It's £3500 for the surgery itself, which is incredible. I have to go all the way to Turkey to have it done, which isn't ideal, but I'm now raising money for my top surgery and all that comes with it. I can't do it on my own. I thought I could, but it's just not doable.
It's been a journey. I used to think it was quite negative – "I'm stuck in the wrong body" – but I will be who I am. It might not be tomorrow, but it will happen.
An NHS spokesperson told POPSUGAR: "The NHS is working hard to reduce waiting lists across all services - NHS England has more than doubled investment in gender dysphoria services in recent years and increased the number of gender dysphoria clinics in England from seven to 12.
"The rollout of five new adult clinics since July 2020 is already helping to address long waiting times, which had increased due to a shortage of specialist clinical staff to meet the rapidly rising demand."
The NHS also states that the requirements for assessments are undertaken according to the needs of the individual, but service specifications require two core assessment appointments at a Gender Dysphoria Clinic, as well as a pre-operative consultation with the surgeon if referred for surgery.
You can donate to Xion Ioannou's top surgery here. If this story has affected you or someone you know, you can speak to Mermaids on 0808 8010400 Monday to Friday 9am-9pm.
— As told to Gabriella Ferlita
