Types of Surgeries for Non-Binary People

Gender surgery, also called gender-affirming surgery or genital reassignment surgery, encompasses a set of surgical interventions aimed at aligning a person’s body with their gender identity. These surgeries allow modifications to body areas that are socially associated with being masculine or feminine, reducing the dissonance that some people experience with their bodies.

For binary trans people—trans men and trans women—surgery is usually aimed at masculinizing or feminizing in a more defined way so that their outward appearance reflects their gender identity. For non-binary people, the needs are different: many seek to neutralize, soften, or adapt certain physical characteristics without having to fit into a rigid male or female pattern.

That is why gender surgeries for non-binary people must be highly personalized and designed through a process of support and shared decision-making, respecting the autonomy of the non-binary patient.

Non-binary people are those who do not identify exclusively with either the male or female gender. They may feel somewhere in between, fluctuate between genders, or identify outside the binary spectrum altogether. This experience is legally and socially recognized in a growing number of countries and is increasingly visible in healthcare.

It is important to note that not all non-binary people want medical or surgical interventions. Some find it sufficient to express their identity through clothing, name, or pronouns. Others, however, feel the need to modify their bodies with hormones, surgery, or both, in order to achieve greater physical and emotional well-being.

While gender-affirming surgery in a trans woman seeks a more feminine body and features, and gender-affirming surgery in a trans man seeks to masculinize the body, the goal of gender surgery in non-binary people is to adapt the body to their own unique gender identity. This may involve procedures to remove certain aspects—such as mastectomy to achieve a flat chest (the most requested surgery among non-binary people assigned female at birth)—techniques to create a more neutral appearance in body contouring or facial features, as well as other surgical adaptations tailored to each individual’s life project.

The key is that there is no single surgical path: each non-binary person defines, together with their medical team, which changes best align with their identity.

Approaching gender-affirming surgery in non-binary people must be fully personalized and adapted to how the person experiences their identity. At IM GENDER, the most requested surgeries among non-binary people are:

Non-binary mastectomy

The non-binary mastectomy is the most common surgery among non-binary people. It involves partial or total removal of breast tissue to achieve a flat or more neutral chest.

• • It may or may not include the preservation and repositioning of the areola-nipple complex.
  • The technique is adapted to breast volume, skin elasticity, and desired results.
  • The goal is not always to achieve a fully “masculine” appearance—often the aim is simply to remove the discomfort caused by the chest.

Vulvoplasty

Vulvoplasty is a genital surgery that constructs external female-appearing genitalia without creating a functional vaginal cavity, unlike vaginoplasty. It is a gender-affirming surgery requested by non-binary people assigned male at birth who do not identify with their natal genitalia.

Other possible surgeries

• • Orchiectomy (removal of the testicles), to reduce male hormone production and the need for blockers.
  • Hysterectomy (removal of the uterus), in people assigned female at birth who want to reduce dysphoria associated with internal organs.
  • Facial surgery (softening or neutralizing features).
  • Body contouring (liposuction, shaping of hips, buttocks, or abdomen).

Each procedure is chosen based on the individual’s needs and expectations, without a predetermined script.

The results of gender surgery in non-binary people depend largely on the chosen intervention and the patient’s expectations. However, most non-binary people who pursue gender surgery seek for their body to better reflect their identity and to reduce gender dysphoria—that is, to lessen the distress caused by certain body parts not aligning with their felt gender—or to improve emotional well-being and self-esteem. Ultimately, the goal is for the non-binary person to feel greater coherence with their own identity.

For this reason, communication between doctor and patient must be very close and transparent in order to achieve the desired results.

The benefits of gender surgery for non-binary people who feel they need it go beyond possible physical changes. Some of these benefits include:

• • Psychological well-being: reducing dysphoria decreases anxiety and emotional or psychological distress.
  • Authenticity: allows them to live more coherently with their gender identity.
  • Autonomy: reinforces each person’s right to make decisions about their own body.
  • Visibility and representation: contributes to broader social recognition and respect for non-binary identities.
  • Improved quality of life: both socially and in daily life, as they feel more comfortable with their appearance.

However, it must be stressed that gender surgery for non-binary people is only indicated for those who feel they need it. Many non-binary people live in harmony with their bodies without requiring any medical treatment or surgery. What truly matters is that each person can decide what changes, if any, they want to make to their body.

The key lies in professional support, clear information, and absolute respect for each person’s autonomy. At IM GENDER, we understand that every identity is unique, and we support non-binary people in this process with sensitivity, professionalism, and commitment.