In the United States, most people are assigned both a biological sex and gender at birth based on their chromosomes and reproductive organs. However, there is an important distinction between biological sex and gender. Biological sex, such as male or female, commonly refers to physical characteristics. Gender refers to the socially constructed roles, behaviors, and actions people take on, usually in relation to expectations of masculinity or femininity. As of 2022, there is disagreement over the relation between sex and gender. People’s biological sex and gender greatly influence the way they understand themselves, as well as how others treat them and how they interact with society. Moreover, some people’s gender differs from what they were assigned at birth, and they face discrimination, harassment, and violence. Evolving understandings of gender and sex in the US have created more ways for people to live and express their gender identities.

Gender-affirming mastectomy is a type of surgery that removes breast tissue, tightens the skin, and can adjust nipple placement to provide the desired results of a more masculine-looking chest. Mastectomies started as a way for surgeons to remove breast cancer and tumors from the breast tissue. However, as of 2022, surgeons also use the procedure as a means of gender-affirming surgery for transgender and non-binary, hereafter TNB, individuals. If a person identifies as transgender, their gender identity differs from the sex they were assigned at birth and the gender they were most likely raised as, which can produce gender dysphoria, a condition that can last a lifetime. Non-binary individuals may have a similar experience, but they identify outside of or between the identifiers of man and woman. Gender-affirming mastectomy, sometimes called top surgery, improves the quality of life for people who seek the appearance of a masculine chest to both better integrate themselves into society and lessen the mental and emotional burden of gender dysphoria.