A few years ago, Stephan Rivera, a 31-year-old native of the Bronx, New York, consulted two doctors about his prospects for “top surgery,” a double mastectomy. “I was like, I really just want to cut them off,” he recalls. Although he was generally content —working as a teacher’s aide in a public school and living with his fiancée, Tanisha Burgess— he felt increasingly estranged from his body, especially his chest. He avoided the mirror after his morning shower; trips to the beach made him anxious. His best friend, Aden, who had recently transitioned himself, told Rivera to seek out the Callen-Lorde Community Health Center in Manhattan.
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