Today and next week, I will be posting a two part series from a wonderful friend of mine. John started as a customer, but we quickly realized how much we had in common as people and became fast friends. When I relaunched the blog, I asked him if he would be interested in revisiting his journey with gynecomastia, especially as he had more time to think about and process his feelings. Thankfully, he enthusiastically agreed, and you’ll find part 1 below. Even if you are a non-binary or female reader, John makes some excellent points about toxic masculinity, the nature of having breasts, and why we need to make the choices which work best for us. Enjoy!

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Gynecomastia:
Or When Man Boobs Are Not Man Boobs

By: John D

I would like to thank Erica for having me back on her relaunched blog to ruminate about my life and my views and experiences with gynecomastia. It’s an honor and a privilege.

First, who am I? I am a straight cisgender male, and I have been my entire life. I developed breasts when I entered puberty, and they continued to develop well into my early 20’s. I have what society calls a “feminine looking chest.” Bluntly stated, I have boobs. Noticeable boobs. D+ size boobs. (Yes, multiple D’s.) And all the joys and pitfalls that come from developing mammary glands, or “overly developed” when referring to men. I have lived with them every day since I was 14. I have a condition known as “gynecomastia”.

What is Gynecomastia?

Gynecomastia is a medical term from the Latin gyne, meaning woman, and mastia, meaning breast. It is not a disease or virus, and it is not contagious. It’s hormonal. Gynecomastia can also be a side effect of certain medicines, such as antidepressants, antibiotics, chemotherapy, prostate cancer medicines, and/or ulcer or cardiovascular medicines. Testosterone replacement therapy can sometimes cause gynecomastia as can unsupervised use of certain drugs like anabolic steroids. Some plant foods are naturally high in elements that can mimic estrogen and stimulate breast growth as well as some GMO foods.

There is also a segment of the male population who develop gynecomastia for no discernible reason, known as “Idiopathic Gynecomastia.” As I put it: You won the boob lottery. I want to note there is such a thing as “false gynecomastia” originating from fat deposits due to weight gain, sometimes cruelly called “man boobs,” which is not the same as medical gynecomastia.  

The Cleveland Clinic defines gynecomastia as “an enlargement or swelling of breast tissue in males. It is most commonly caused by male estrogen levels that are too high or are out of balance with testosterone levels.” True gynecomastia is where some level of mammary tissue develops in men beyond the normal amount, and the breast appears more female in shape.

The condition varies by individual from unnoticeable to well-endowed and impacts roughly 50% of all males sometime in their lifetime with 10% to 15% of those men having moderate to severe gynecomastia. Societal stigma undermines the commonness of gynecomastia with the vast majority of cases going underdiagnosed.

Gynecomastia itself is non-cancer causing. Men can develop breast cancer, with or without gynecomastia. Men are generally 100 times less likely to develop breast cancer than women as a whole, but it is not uncommon for some men to have mammograms, whether they have gynecomastia or not.

Gynecomastia in My Teens

Like many men with gynecomastia, I am happily married to a wonderful woman, but it was not an easy road to get here. I didn’t ask for my condition. I looked down one pubescent day and saw two mounds of flesh on my chest that continued to grow into breasts. I was not overweight (that came MUCH later) but a slim and active teen, only furthering the appearance of my chest. I was bullied, teased, and publicly humiliated because I had breasts, larger sometimes even than girls in my classes.

Intermural sports were hell. I was always picked for the “Skins” team and having my chest exposed and jiggling devastated me as my peers mocked and groped me during play, often causing physical pain in addition to emotional trauma. I stopped playing sports altogether.

Toxic masculinity and its need for men to be “manly” exacerbate these feelings, leaving us isolated and afraid to voice our mental health concerns.

Dating was also problematic as a teenager because most girls did not understand how to deal with a guy with a bust. Gynecomastia embarrassed me and created shame, and over time; body image issues, and health problems, including obesity, in trying to deal with it. Many men, like me, develop anxiety, depression, and fear. Toxic masculinity and its need for men to be “manly” exacerbate these feelings, leaving us isolated and afraid to voice our mental health concerns.

“How can I be ‘manly’ when I have ‘girly’ boobs?” Obviously, few men boast the “perfect male physique,” but the pressure to have that body type while also having a feminine chest, even a small one, spawns crippling self-doubt for many of us. Gynecomastia felt like a life sentence of embarrassment and shame. Was I ever going to be “man” enough?

On several gynecomastia forums, it is common for teen males asking if they “have it,” like it is a fatal disease and asking about surgical removal as young as fifteen. The majority of teens have nothing to worry about but that doesn’t stop the anxiety and fear as they look at their chest in dread.

How many of us of all genders have been made to feel badly about ourselves because of the size and shape of our chests?

Approximately 50% of teenage boys experience some form of self-reversing gynecomastia with most undetectable or very minor. Hormones flood the system, and estrogen usually initiates the first wave either naturally or through aromatizing of excess testosterone. Often swelling disappears, but too frequently, the trauma remains. Gynecomastia can also present at birth from hormones in the womb as well as after the age of 50 due to decreasing testosterone. For me, the teenage years left lingering scars I am still coping with now.

We All Have Breasts

Breasts became associated solely as female, much to the chagrin of men like me, non-binary people, and women with smaller busts. Society fixated on breasts as being a sexual object, sometimes going so far as to consider them an apex of femininity and virility in women. Not all human breasts develop. As males can develop gynecomastia, women can develop micromastia, or the post pubertal underdevelopment of a woman’s breast tissue. How many of us of all genders have been made to feel badly about ourselves because of the size and shape of our chests? No one should ever feel “less than” because of a biological issue which does not fit some arbitrary norm.

Furthermore, chest support should never be defined by gender but rather need and desire. If a person does not feel the need to wear a bra, that is their choice. Likewise, if a person feels more comfortable or confident wearing one, then they should be free to do so. No one should care in either case. It’s a personal choice, and nobody else’s business.

Body shaming happens to everyone, and I know firsthand how hard it is to be accepted for having gynecomastia, more than I would even like to admit. I have been discriminated against because I have a no-no trait for a man, “girl boobs.”  Some assume, since I have a chest, I must be feminine, transitioning, or “perverted” and treated me negatively due to their own hang ups around a gender-based bust size.

I made the choice to start wearing support for comfort and containment as do many of my peers. It isn’t about looking feminine if you have gynecomastia, although that is fine if some are inclined to do so. Until companies market bras specifically for males with gynecomastia, we have to shop in lingerie stores and departments to meet our needs, most of which are styled with a more feminine idea in mind. Breasts, with or without, do not define a person. We need to see the individual, not what they lack or what they have extra. With chests in general, we need to stop sexualizing them and view them for what they are: a body part, like a hand or a leg.

The Effects of Toxic Masculinity

I have never shared anything about my condition with my male friends because I can’t explain it in a way they comprehend and appreciate. It remains the elephant in the room. Other gynecomastic men also acknowledged they too can’t explain the stigma and how it feels to those who have never experienced it. We do not want to be marginalized or re-traumatized from our earlier experiences.

Toxic masculinity made men competitive. The rise of terms of like “alpha male” mean being considered a “sissy” feels worse than death. The perceived lack of maleness ruins reputations and makes us not only less of a man (in my case) but more importantly, less of a human. We are prime for ridicule and judgment. I have experienced many issues my female friends have. Eyes squarely fixated on my chest and nowhere to hide the two projecting orbs. On one occasion, I told a stranger, “My eyes are up here.” The uncomfortable encounter revived feelings of shame and vulnerability. I get your anger and frustration ladies. I feel it too.

Like many gynecomastic men, I hid my breasts underneath oversized clothing, layering, binding, or minimizing their presence. Some of us consider surgery. For me, the biggest reason is cost. Insurance will not pay for a male mastectomy or breast reduction. It is considered cosmetic surgery in males unless it can be shown there is a medical need, e.g., cancer, and it can be quite expensive depending on what needs to be done. There is also the risk of complications from anesthesia or from the surgery itself.

Gynecomastia is shrouded in so much silence that even male primary care doctors, unless the patient brings up the situation, will not normally discuss the possibility of the condition.

Like people who pursue reductions, surgical revisions are occasionally required, and the final appearance may not be as expected. Scar tissue is one of the main issues with the surgery. It does not always fade, leaving a mark of history on your skin. A sizeable number of men do have the surgery with varying results and satisfaction. An online search of surgeons advertising the procedure bears this out, but many more men like me opt to not have the surgery and deal with our developed chests.

There is one man I am personally familiar with who had reduction surgery for moderate gynecomastia only to have it return 10 years later. He decided to live with his redeveloped breasts and wears a bra now instead of going through another procedure. Statistics on the number of men who keep their breasts are unknown but is suspected to be considerably higher than those who have surgery.

Gynecomastia is shrouded in so much silence that even male primary care doctors, unless the patient brings up the situation, will not normally discuss the possibility of the condition. In my own case, a woman doctor broached the subject with me as an adult when she requested to perform a breast exam during an annual physical. It was an awkward experience, but I am grateful she took the initiative. I never would have, but my male doctors never even mentioned it.

Her diligence began me on a long, rocky journey of acceptance. Until then, I thought I was the only one in the world who had “this problem.” I had been conflicted for years about what it was or meant but also what I should do. To this day there are many people who have never heard the term ‘gynecomastia’ or know what it is.

I have finally, after many years, learned to be comfortable with my body and sometimes “the devil you know” is better than “the devil you don’t.” I’m looking forward to sharing the rest of my journey in my next post.