Sam's Top Surgery!!

Hello, my name is Mac Popetz, and this is a fundraiser for my boyfriend, Sam Weiss. Sam is a nonbinary trans-masculine person seeking chest reconstruction, AKA “top surgery”. As you may be aware, trans people often have to jump through hoops to get gender affirming surgery. Insurance companies notoriously exclude these surgeries, and for those without insurance, the cost of surgery is prohibitive. Many surgeons won’t do surgery without a note from a therapist, and often we need to have years of hormone replacement therapy under our belts (which excludes those who don’t want to, or can’t, take hormones). 

One hurdle that doesn’t get much attention in these discussions, though, is fatphobia—something the medical world (particularly the world of plastic surgery) is rife with. Many surgeons who do top surgery require patients to be under a certain BMI. For those who aren’t familiar, BMI (Body Mass Index) is an equation based on height and weight, developed in the 1830s by a mathematician to measure people’s physical appearance (not health) for statistical analysis. Today, BMI is used to shame and exclude fat people in all sorts of ways.

Sam is 5’9” and about 300 lbs, which puts their BMI well above these limits. In order to slow their hereditary kidney stone production, they’ve been working with a licensed dietician, who has never recommended weight loss for their health. (Their kidneys are doing great, if you’re wondering.) After months of unsuccessful consultations with surgeons, they got close to giving up hope. Even ignoring how difficult it is to lose weight during the early stages of hormone replacement therapy (sometimes called “second puberty”), deliberate weight loss is an emotionally fraught process. Most fat people are told their whole lives by doctors, media, loved ones, and strangers that they can’t be healthy or desirable unless they lose weight. The near-inevitable internalization of those messages can be a slippery slope to an eating disorder. Sam told me on more than one occasion, sometimes jokingly, sometimes not, that they might as well starve themself so they could meet surgeons’ demands.

The reasons these surgeons gave for the BMI limits were all over the map. One said it was too dangerous to anesthetize them. Interestingly, Sam has safely undergone multiple anesthetizations for surgeries related to their kidney stones. This surgeon did not have an explanation for how they anesthetized people with similar BMIs for weight loss surgeries. One surgeon, who never saw more than a waist-up photo of Sam, said their shape and size would so drastically alter the post-op healing process that it wouldn’t be safe to perform the surgery. Another said they could do it but for double the cost. The one surgeon who would take Sam’s insurance baldly admitted he believed the surgery results would be more aesthetically pleasing if Sam lost weight first.

The adverse effect these consultations had on them can’t be overstated. Compromising their schedule to run from surgeon to surgeon (all of them cisgender people who could use some serious brushing up on how to talk to trans people about their bodies and genders), and being told time and again that their fat body was the problem for multiple (sometimes contradicting) reasons, was confusing, demeaning, and infuriating.

In late August, after some serious sleuthing in a top surgery-focused Facebook group, we drove up to Minneapolis to consult with Dr. Jacqueline Luong. Before deciding to book a consultation, Sam had called to ask her about BMI limits and cost, and though her responses were promising, the series of dashed hopes preceding our trip gave Sam good reason for trepidation. But Dr. Luong exceeded expectations. She didn't mention Sam’s weight or their body other than to ask how attached they were to the Kony 2012 tattoo they have under their boob. She let them know they’re a good candidate for the surgery, and Sam left elated. 

The surgery is set for March 16, 2020, and we need to be able to pay the surgery and hospital fees 3 weeks in advance.

Here are the costs broken down:
$7000 (surgery cost)
$3,000 (hospital/anesthesia fees)
$2,000 (travel costs—hotels, food, gas, pet sitter, etc)
$1,000 (I work hourly & will need rent/bills/food money since I’m staying in Minneapolis to be with Sam for surgery, care for them post-op, and go to a post-op appointment)

In Sam’s words, “It is hard for me to be vulnerable in this way, but I am feeling thankful for other people who have shown it to help me not feel so ashamed and scared. […] This has been such a heartbreaking and valuable experience. I am proud of myself for not falling into dangerous eating habits to do what someone else thought would be best for my body. I feel strong for holding out and going the route I feel most comfortable with even though it feels equally as hard. The support I have has been life changing.”

The impact everyone’s donations have had so far has been incredible, and both of us thank you so, so much. We still have a long way to go, though. Thank you in advance for giving what you can, and for investing your time in Sam’s life.

Donations ()

  • Nicole Siefert 
    • $50 
    • 3 d
  • Anonymous 
    • $5 
    • 9 d
  • Katie Burke 
    • $5 
    • 9 d
  • Mairead McNameeKing 
    • $20 
    • 13 d
  • Barbara Barbara 
    • $500 
    • 15 d
See all


Sam Weiss 
Chicago, IL
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