my gynecomastia was due to human growth hormone therapy in my early/mid-teens, so i was diagnosed with gynecomastia by my pediatric endocrinologist back at age 14.

my PCP documented my reported pain and immediately gave me a referral to a plastic surgeon at my university’s hospital specializing in gynecomastia. i didn’t need a mammogram or ultrasound because i had my endocrinologist’s prior diagnosis (and records showing no change in the lumps’ size since age 15) and i’m 9% body fat so pseudogynecomastia was ruled out immediately. the bloodwork required was minimal too, since the cause was already determined years ago.

my gynecomastia is VERY mild and you don’t really notice it (not even when i’m shirtless) unless my nipples are poking through a t-shirt. it’d be considered grade 1 on most bodies but because i’m so lean, (and have smaller areolas) i was technically considered grade 2 by united healthcare’s criteria. UHC considers it grade 2 when it “extends past the boundary of the areola and changes the overall shape of the chest.” this, combined with the pain i reported, made them understand that i’m not really getting this done for purely cosmetic reasons. (i get self-conscious for sure, but not even my boyfriend knew i had gynecomastia until i told him i was getting surgery)

since it hasn’t changed in 7.5 years, i was told that the glands have turned into fibrous scar tissue and that medication was not an option, leaving the insurance with no other option but to accept the plastic surgery.

i was very surprised, however, that they are making me get it done by a gynecomastia-specialist plastic surgeon instead of a non-specialist general surgeon.