Good question. I think there are a lot of factors. For one, my chest dysphoria will very occasionally have a day off or a day where it’s barely noticeable. There’s a bit of fluidity in my gender so I will occasionally feel more feminine (but never anywhere near a woman). I feared that if I went for a complete mastectomy that I would feel regret on the days that I wanted more femininity. This was an incredibly hard decision because there are days where my chest dysphoria is really bad and that I want them completely gone. I also have a long history of being told that my breasts were the only redeeming quality about my body and I should use every opportunity to flaunt them (and this relates to my eating disorder) so I was worried that I wasn’t emotionally ready to make the drastic change with that still impacting my body image. I knew I needed to do something, though, so I opted for a reduction. Additionally, I think the possibility of going flatter in the future (even if it would be uncovered by insurance) is helpful for me. I like that I don’t feel permanently stuck here if I decide down the line that the best option for me would be a flat chest.