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“Becoming the Man I Want to Be”: Charley’s Gender-Confirmation Surgery

Charley Burton, a transgender male who had gender-confirmation surgery

Charlottesville resident Charley Burton identifies as a transgender male and receives gender health care at UVA. For years, he longed for a body that fit his gender identity and finally had a double mastectomy and hysterectomy in March 2021. Here, he shares his story with us.

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Transcript: CHARLEY BURTON: I'm Charley Burton. I'm a native of Charlottesville, Virginia. There's a picture of me as a little kid, and you can't tell that I wasn't a little boy. I always knew. My body just didn't match my mind. And I pushed that in for the next 30, 40 years until I became 50 years of age and started my journey. REAGAN THOMPSON: When I first met Charley, he was pretty frustrated. He had hit a lot of barriers getting appropriate transgender care and had given up on our system. CHARLEY BURTON: And so when I go to the hospital, there's this level of anxiety that builds up in me every time. But I've been lucky because I've had a Reagan Thompson in my corner. She truly wants to know, what can she do as a medical professional to make my life better? REAGAN THOMPSON: I think it's super important to listen to your patients and try to figure out what they're angry at. CHARLEY BURTON: She has seen me at my lowest. And she now sees me where I'm at today. [MUSIC PLAYING] CHARLEY BURTON: Today's the day that I have my top surgery. Top surgery is the removal of the breasts. It's another stage in my transition. So I'm a little nervous today. Nervous and excited. JT STRANIX, MD: It's impossible not to like Charley when you meet him. We talk about what the goals are for surgery. His, in particular, were to have a chest that was congruent with his male identity. SPEAKER 1: And can you tell me what Dr. Stranix is going to do? And Dr. Sopata? CHARLEY BURTON: Yeah, we're doing a double mastectomy. SPEAKER 1: OK. CHARLEY BURTON: The top surgery. SPEAKER 1: Yup. CHARLEY BURTON: And total hysterectomy. CARRIE SOPATA, MD: Trans patients should feel comfortable coming to any location in UVA and knowing that they're going to get the right care and the best care. CHARLEY BURTON: There was this one nurse. One night, she came in and she just wanted to know so the next person that comes on her floor that has had top surgery or is trans, what could she do better? And she asked some of the most beautiful, poignant questions. It was just total respect. JT STRANIX, MD: In my mind, a successful gender-affirming surgery is one that makes a patient feel more comfortable with their gender identity and really improves their overall well-being. CHARLEY BURTON: The first day that I was able to take the ACE bandages off, I saw the chest that I've always wanted and it was-- I'm getting emotional now. It was just 10 times more than what I thought it would be. REAGAN THOMPSON: And now Charley is a very happy person with very few complaints, and has a desire to fix a system that is driving him to be more involved in the transgender community. CHARLEY BURTON: I'm becoming the man that I want to be. I am confident in who I am, and I never thought I'd ever be there.

The day I received the call from plastic surgeon JT Stranix’s office, I really was not sure I was hearing the employee, Destiny, correctly. “You have been approved, and let us set up your surgery date.”

I have wanted this for about six years. Three years prior, I was denied. I watched everyone else in my circle of trans brothers getting their surgery dates, showing their results. I did not want to go into the “Why me?” mode. I just continued to do the work I needed to do to help others.

I had resigned myself to the fact that gender-confirmation surgery — a hysterectomy and a double mastectomy — would never be a part of my transition. I lacked confidence without the surgery, although I knew how to fake it until I could make it.

I had always wanted to have my surgery close to home. I had wanted my surgery to be at UVA. When I heard that my previous doctor was no longer there, it brought on some anxiety. But then my nurse practitioner, Reagan Thompson, informed me that there was a new surgeon performing top surgery.

I had to go through so much with my insurance. First, I was told they did not cover. Then I was told that they did. I kept getting bounced around.

Taking Care of Me

I made sure I had up-to-date tests and a mammogram. It is important to me to take care of my health. For so many years I had not. It was important to me that, if there was a slim chance of getting this surgery, I was healthy enough to have it.

Going for a mammogram looking the way I looked was a challenge. It is COVID, and I had to go to these appointments alone. I found that strength and courage to do everything I needed to do. I was so close to being able to feel my authentic self. Every week I would slay one more dragon closer to that March 25 surgery date.

Am I Doing the Right Thing?

About 2 weeks before my surgery, I started having doubts. What if it is botched, and I will not have the chest I expected to have? I am not a small guy. Can this doctor do the right thing? But I liked Dr. Stranix’s style, and I felt comfortable. I trusted Reagan’s recommendation.

What would it feel like to not have breasts? Would it be what I wanted? I am removing a piece of my body that I have had for 60 years. Will I ever date again, and would someone want me with these battle scars? So much going on.

I felt like I could not talk to anyone about this. So, I just did what I did best: stuffed it in.

Every appointment I had went so smoothly. For the first time in my journey, there were no potholes that I was hitting, forcing me to take a different route.

Two Surgeries

I had two surgeries at the same time. The hysterectomy and the top surgery. Somehow, I never had anxiety about the two of them. I knew how important the top surgery was, even with moments of doubt. This was to complete and save my life. It was not for vanity reasons. It was to live.

Again, there could not have been a better person to have besides gynecologist Carrie Sopata, MD. The first appointment: again, lots of anxiety, anger, and fear. Here I must go to the third floor of the women’s OB-GYN clinic. If there was ever a reason to be grateful for COVID and mask wearing, it was when I would go to that clinic. I could hide the beard and mustache. Still, I was sure there would be questions.

All on my own, I mustered the strength to go every time. I was not fearful of the nursing staff or doctor. But I wish I’d had someone to just be my cheerleading team. COVID made my whole experience very lonely.

Surgery Day

March 25. The day that would change my life. I have had so many milestone “change my life” days:

Again, with COVID, my sister dropped me off at the door. But what a relief to have UVA video producer Nate Braeuer there. Someone I had created trust with. Everything moved so quickly and so well, I cannot remember a lot. I just knew in a few hours, life would be different. Lots of questions and different people. Each person made me feel valued. I knew I was in good hands.


I remember waking up and feeling my chest. It was done. Even through the pain and bandages, I knew that life from now on would be different.

My overnight stay could not have been any better. I was afraid. But the nurses turned out to be kind, caring and nonjudgmental.  I remember sleeping a lot. But I also remember the great conversations I had with those nurses about my life and what this surgery meant to me. I felt valued. I felt like a human being, something that was lacking for so long.

LGBTQ Healthcare

Most LGBTQ people experience healthcare discrimination.

There was one slight problem: I was told that I would be provided a compression vest that I would need to wear. The staff thought I had my own. Seems small, but the miscommunication was a big deal when it comes to recovery.

3 Months Out

I am now 3 months out. I had an opening of a wound that I must pack twice a day. I still need to have a hernia repair. My chest looks great, but the big hernia in the middle sort of lessened my feeling totally great. But it will get repaired. The wound is healing.

Charley with his nurse practitioner, Reagan Thompson

My feeling about myself and my life is so different. Almost like the day I got my first T shot.

This was when I finally realized what this was all about: I am at my desk taking a class. I need to run out quickly during my hour break. I grab my keys and stop in my bedroom, thinking I need to pull my shirt off and put on my binder. I realized I do not have to wear a binder any longer. I can just walk out the house.

Most mornings, I must smile. I take my shower, dry off and put my shirt on. My skin feels the softness of the fabric. How it falls over my head and onto my chest. It is then I know deep in my soul – I did the right thing, and my life is where it needs to be today.

Thank you, Reagan Thompson, Dr. Sopata, and Dr. Stranix for being the vessel steering my ship in the right direction.

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