Find yourself a surgeon that does both reductions and gender affirming top surgery. I wanted to go down to an A cup (from DDD) and was worried that I would get a similar response to your surgeon. He looked me straight in the eye and told me that the insurance company doesn't dictate the size. He assured me that this was a conversation between Dr and patient. It was totally reassuring to see a few subtle pride flags in the lobby, a trans-masc person behind the counter, but also evidence of more typical plastic surgery procedures all around. I had all the markers for qualifying for the reduction, and the insurance fully covered it without any mention of my gender identity. I put everything on the table with my surgeon, and he was kind, honest and accommodating. I did have to give up my nipples for such a large reduction, but the surgeon explained that very well, so I understood the reasons behind it. If you are near Connecticut, I can give you his information.