Fall of a Scar

By Adrian Kaleb Quijano

Trying to get top surgery is absolute hell. And I’m one of the lucky ones. I live in Canada. I have a family doctor who listens and has helped me through my transition. I have a supportive partner, friends and a community that wants to help. I’m writing this within days of the United Kingdom ruling that excludes trans women from the definition of women. My Lola, tagalog for Grandmother, does not want to return to her home in San Francisco because she’s afraid of Trump. She, as a cisgender, heterosexual woman, is afraid to return to a country she’s been living in for most of her adult life. 

I don’t want a medal for trying to live my life, even though those in power are trying to legislate me out of existence. Trans people deserve to get their flowers now while they’re alive. We aren’t some statistic or graphic you can swipe away from on Instagram. After talking with older trans folks, the common thread that connects trans people throughout generations and genders is our struggle. Watching our identities and rights systematically repressed.  

I’m not completely sure when I tried to access top surgery for the first time. I remember how I felt, though: exposed and vulnerable. Similar to how I felt when I started talking about testosterone. If the train of thought was real, mine would never be on time and be driving on several different tracks at once. After Trump got elected again, my train smashed repeatedly into the wall of ‘we-need-to-do-something-now'. I needed to access trans healthcare ASAP. When I made the appointment with my doctor, I had already spoken with him about McLean Clinic – a private plastic surgery clinic focused on top surgery. 

I was in a work meeting when I got the call from McLean’s. I jumped up from the couch to take the call on a secluded staircase, and I remember speaking with the inappropriately chipper person about the fate of my chest. She told me that my BMI was too high for McLean’s to work on me. I had three options: lose weight, go on the waitlist for the Women’s College clinic, or I could do both. In my shock and anxiety, I just said yes. I’m not sure if it was a general yes to everything or one of the options; I just wanted to hang up and get on with my day. Which is wild because, how does one carry on when you get a call from a clinic telling you, ‘You’re too fat’? After waiting for over a year, I might add.  

Holding my chin high and puffing my chest out, I went back to my doctor. I told him what happened, and he wrote a friend’s name on a scrap of paper I still have pinned to my desk. He knew her personally and wanted to refer me to her. This gave me higher hopes for accessing top surgery sooner because of what I had heard from other trans folks. ’It’s always better if your doctor knows a doctor.’ 

Turns out my trans forebearers were right, as they often are, and I was contacted within a few days. The office manager told me I would be able to see the doctor in a matter of weeks. Shocking, considering I’d had to wait a year already and was anticipating more of the same.  

Basically, I sped-run my rejection – through a series of manic highs and deep depressions. I felt like Hercules sent on an impossible task. I was warned that my BMI may be too high, but they gave me a consultation anyway. I had low expectations and I believed some information was better than none. 

Half-naked and anxious, I sat with my top half covered in a hospital gown while waiting for the doctor. 20 minutes later, I was under the impression that there was high likelihood I would be getting my top surgery done there. Then came the price tag, I was handed a glossy blue binder with numbers that were bigger than expected. However, I would not be deterred – I was excited, elated! I was probably going to get top surgery this year!  

It hardly felt real to me. The final hurdle was meeting with the anaesthesiologist the next day. But even that went well. My BMI was on the higher end of their patients, but he didn’t think his team would have any problems with me. That weekend I posted a link to my GoFundMe for the operation, and shared it to my personal accounts on Instagram.  

And then Monday came along. The surgeon called to say they wouldn't operate because some folks on the anaesthesiologist team did not feel comfortable operating on me. Then she tells me I should go on Ozempic. 

Let me be absolutely crystal clear: I am not losing weight for this surgery. I do not think I should have to lose so much weight to access healthcare. They told me I have to take my 45% BMI to a 40%. Let’s say I do lose weight, if I even entertain that idea, I would only be comfortable doing it in a healthy way. But I can’t wait. I want to access top surgery as soon as possible given the increasing attacks on trans rights in North America. I want to do this surgery on my terms in my way; it’s all about bodily autonomy.  

So I found myself again at the top of a ladder being told to jump. Being told no and to keep going.  

Weeks ago, after my second try at stand-up comedy, a kind stranger tapped me on the shoulder. I was doing a stand-up piece about my struggles with the healthcare system and trying to access top surgery as a fat, trans person. Hilarious, I know. This person wrote down on the back of a sticker the name: Kawartha Plastic Surgery. They told me about how this clinic did not have a BMI limit and that their waitlist was only about 8 months. They and their friends told me they’d seen me perform at an old pub, now long gone. I was elated to the point I couldn’t even speak. I wish I could have made friends with them.  

My GoFundMe page got over its goal in under 24 hours. Many community members, including talented writers I respect, have encouraged me to write about my experience. So here I am, trying to get my story out there.  

UPDATE: As of August 2025, Dr. Chung from Catalyst Surgical in Toronto has agreed to take on my case, provided we conduct breathing tests to accommodate my body's needs. My first breathing test will take place in October this year. 

---

BIO: Adrian Kaleb Quijano (he/him) is a queer, trans, Filipino writer and content creator who has spent much of his life reimagining his world. He has been invited to speak at the Kitchener Public Library's ‘Trans Day of Remembrance’ panels of 2023 and 2024. You can follow Adrian on Instagram: @quijanodehmanila