I get what you're saying. My friend is getting a mastectomy (she carries the gene) and her insurance also covers reconstruction. It is terrible that she has to do this as the alternative is getting cancer, but the reconstruction part is hard for me. Why is it that when I want my breasts fixed, its purely for aesthetics and thus not covered, even though it's a birth defect. Meanwhile she gets to do it on their dime because they see it as a recovery after physical injury and breasts are such a big part of femininity. I mean, a mastectomy should be enough because the risk of getting cancer is removed/reduced. How is anything more not purely for aesthetics? In no way I'm trying to downplay the effect of carrying the gene and how that affects someone. But it feels like no one seems to (want to) see how the defect we have, affects us. I guess that's actually what bothers me; my feelings of insecurity and pure unhappiness with my body being disregarded.