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When it comes to body insecurity issues, few problem areas provoke more fear in men than “man boobs.”
Caused by an imbalance of testosterone and estrogen, gynecomastia is the medical term used to describe the benign swelling of breast tissue, which can create the appearance of breasts.
“In most men, this tissue stays dormant and ‘asleep’ and the small amount of tissue there is shrunken and pretty much undetectable behind a usually smallish and flat nipple,” Dr. Heather Richardson, a plastic surgeon at Bedford Breast Center in Beverly Hills, California, told HuffPost.
For other men, it’s embarrassingly visible.
“Gynecomastia is absolutely a life changing thing for many men,” said Rod Rohrich, a plastic surgeon at the Dallas Plastic Surgery Institute. “They’re often ridiculed by their peers in school or at extracurricular sports. It’s the equivalent of a teenage girl having a crooked nose in terms of the ridicule endured, and social media has made it worse.”
Richardson said gynecomastia, oftentimes shortened to “gyno” on the internet, can happen at different times in life: Some male babies might have puffiness at birth that quickly fades, but many times it’s triggered by puberty, when weight fluctuates and hormonal imbalances can result in a fullness around the chest and nipple area.
“The problem often resolves as testosterone and muscle mass increases and they continue to develop into adults,” Richardson said, adding that gynecomastia becomes noticeable as men get older and their testosterone decreases and often body fat increases.
Why can’t you just exercise it away? Just like most areas on our bodies, you can’t spot treat anything. And because gynecomastia is breast tissue, it’s fibrous and firm, and unfortunately, no amount of working out will melt it away.
As the Mayo Clinic notes, gynecomastia isn’t a serious health problem, though it’s common ― an estimated 30% to 50% of healthy men struggle with it. (The numbers vary drastically because gynecomastia is a relative thing; what’s gynecomastia and unsightly to one man may feel completely normal to another, Richardson said.)
Still, as the men we spoke with for this story said, the harmless condition can be an emotional hell to live with.
“The comments were like ‘you have bigger tits than most of the girls in our year.’”
– Ian Lynam, a 29-year-old comedian and writer
Despite strides we’ve made in body neutrality in recent years, “man boobs” are still considered fodder for jokes in standup routines and boy’s locker rooms.
Ian Lynam, a 29-year-old comedian and writer who lives in Dublin, Ireland, first felt shamed about the slightly pointy appearance of his chest at the age of 13, in the locker room.
He hated changing in front of his peers because of the mockery. “I’d hear things like, ‘you have bigger tits than most of the girls in our year.’”
The bullying was so bad, even new kids at school instantly clocked that his chest was an easy target. “Let me tell you, if even the new kid can pick on you, that’s how you know you’ve reached pariah status,” he said.
As a teen, Lynam did about everything he could do to rid himself of his man boobs. Every night, he’d grab his mom’s dumbbells and spend hours lying on the sofa, doing bench presses.
“I didn’t understand what was happening to my body and even worried that the things on my chest were tumors,” Lynam said. (Again, gynecomastia is not physically harmful.) “I would press on them so hard they would ache: I liked to imagine I could push them down like play dough.”
At 19, Lynam got gynecomastia surgery (also called male breast reduction by plastic surgeons) to remove the excess breast tissue. According to the Cleveland Clinic, every year about 20,000 people get this surgery, which may include liposuction, excision (using larger incisions) or some combination of both. When you search “gynecomastia” on Google, many of the 7,910,000 search results are links to plastic surgeons offering the procedure.
Today, thanks to the surgery, Lynam feels more comfortable in his skin. He also considers the procedure gender-affirming surgery, similar to the female-to-male top surgery that transgender men and nonbinary people get to create a masculine chest. (But for those procedures, trans people usually have to obtain a letter stating the medical necessity of the procedure from a mental health professional.)
“I absolutely consider it that. I’m a cisgender man, and I had physical characteristics that didn’t align with my gender identity, and I received treatment to correct that,” he said. “The only difference is I happen to identify with the gender I was assigned at birth.”
James Peña DeRoach, a 39-year-old from Albuquerque, New Mexico, who had gyno surgery, agreed. “Having male breasts, as a cis male, is awful … You have a body that isn’t yours. I was a man, but I had breasts ― and being constantly made fun of, didn’t help at all.”
DeRoach first noticed his larger breasts when he was about 11 or 12. That’s when he said he was misdiagnosed as bipolar and put on lithium, which caused him to gain weight, and later Resperdal, a drug that’s since been linked to several side effects, including breast growth in males.
“So not only was I overweight, I had breasts, too,” he told HuffPost.
As for name-calling, DeRoach was in high school when “Fight Club” came out and his classmates were quick to label him “Bitch Tit Bob,” the nickname for Meatloaf’s character in the 1999 film.
DeRoach’s doctor told him he’d “stretch out” and lose the breasts eventually. Though he did get taller, he never lost the extra tissue. He was over 6 feet, 185 pounds, and muscular from working out, but because of his gyno, he didn’t dare show off his body. Instead, DeRoach lived in layers in his teen years.
“I wore tight undershirts that I tucked in tightly into my pants, and another shirt I wore over that,” he said. “I also tucked in over that a vest, bowling shirt, or hoodie; depending on the season.”
He even tried using household items like plastic wrap to bind his chest, like many transgender men do, but that came with its own problems like back pain and skin irritation.
“I tried walking slouched over for a time, so my shirt would hang down more, hiding the breasts, but that’s bad for the spine,” he said.
In 2001, DeRoach got the gyno procedure done. (He and his mom fought tooth and nail to get his insurance to pay for the procedure, but they ultimately were denied.)
He still lives with body dysmorphia today, though. As DeRoach sees it, we have a long way to go before men can enjoy a body positivity movement similar to women. We’re still way too comfortable openly mocking men for their physical appearances. DeRoach brought up the example of former president Donald Trump and how every part of his body continues to be mocked.
“I’m not a fan of his but the size of his hands were made fun of. The size of his penis was made fun of. The size of his butt was made fun of,” he said. “The questions about his hair being real or not has been a heated topic of jokes for decades. The toxicity of American maleness and machismo of masculinity is extremely harmful to developing males.”
Tom, a 60-something man from Southern California, has mostly made his peace with his gynecomastia, but he has had decades to do so.
He was a teen at swim meets when his gynecomastia was first brought up by others. (“Yeah, crazy, I know, a guy with boobs wearing only a Speedo in front of people at a swim meet,” he joked.)
Tom, who asked to be identified by only his first name, said there’s one incident he remembers distinctly to this day.
“I was heading to the shower and talking to my crush, who was pretty flat chested, I definitely had more,” he told HuffPost.
“Some of the guys were still in the pool, and as I was talking to her, one of them yells, ‘Hey Becky, give him your bra, he needs it more than you do,’” Tom said. “Needless to say the girl was pissed. I don’t know if she thought I had put them up to it or what, but she never spoke to me again.”
Eventually, Tom got into bodybuilding ― it didn’t reduce his gyno, but it did put his focus on other parts of his body.
“I would do a crazy number of dumbbell curls and look down at my biceps which after a few months were really big,” he said. “The gyno really did not matter as much to me then. Also, the bigger I got the less some smartass was likely to make a comment about my chest.”
He got less and less self-conscious around girls, too.
“I went to a bit of a party school and had sex with a bunch of girls there and none of them ever said anything about my breasts,” he said. “I think most girls are actually more concerned with how they think some guy is going to view their body.”
When he hears other men struggling with the same issue, he tries to reassure them “not to worry about what someone else thinks of their body.” Most of the time, he said, people are too caught up in their spotlight syndrome to care or focus on your chest.
What You Can Do If You’re Struggling with Gynecomastia
Because it’s not discussed enough, having gynecomastia can be an incredibly isolating experience. It’s essential to find a community where you can talk about your insecurities and the impact it has on your life, said Aaron Flores, a weight-inclusive registered dietitian and nutritionist in Calabasas, California.
“When we find community in our shared experiences, it opens the door for some compassion around what we’re struggling with,” he said.
Tom, the older man with gyno, said he found community in the weight room.
“I realized I was not the only one working out in the school weight room that had breasts, especially some of the football players who were heavier definitely had boobs and now I would say had gyno,” he said.
These days online, there’s Reddit groups like r/gynecomastia where people commiserate over their experiences, offer advice, and sometimes speculate about which celebs have had gyno surgery themselves. There’s also a relatively active forum on Gynecomastia.org, a resource site for men with the condition.
On TikTok, the hashtag #gynecomastia turns up videos of body builders and regular sized guys discussing their gyno experience. (Naturally, there’s a lot of gyno surgery-hawking plastic surgeons posting videos, too.)
Recognize that exercise alone doesn’t usually help gyno.
Patients with pseudo gynecomastia ― where the area of concern is essentially fatty fullness on the surface of the chest ― can see significant improvement if they exercise and lose weight, Richardson said.
But patients that have stimulated glandular tissue that’s tough or lumpy underneath the nipple can’t exercise or diet this type of tissue away, she said.
“Men with drooping to their nipples with more protruded tissue may have deflated extra skin that may worsen and become more droopy with weight loss,” the doctor said.
Consider the harmful roots of male body ideals and recognize that you don’t have to subscribe to them.
In the age of social media, expectations for the male body are increasingly hard to meet. Weight stigma and fatphobia run rampant in our culture, and if you’re lucky enough to have “man boobs,” you also might encounter homophobia, too, Flores said.
“I think all the jokes and disparaging comments have a lot to do with being rooted in homophobia: It’s the idea that a male body even being mildly perceived as female or having female characteristics insinuates that this person is less than a man and that’s really not OK in our current society,” he said. “I think there’s still a lot of masculinity rooted in fear of being perceived as gay or female.”
If you recognize how wrongheaded the basis of our culture’s body ideals are, it’s easier to discount them, he said.
If it’s really bothering you, look into treatment options.
While surgery is not your only option ― as Flores said, “there are other things that folks can do to work around body image and improve their life and feel more comfortable in their skin” ― it is an option that some with gynecomastia choose to pursue.
Rohrich, the plastic surgeon, does about 30 gynecomastia surgeries a year. For a ballpark cost, he told HuffPost it can vary from $4,500 to $7,000.
“What men need to know is that gynecomastia is common, easy to diagnose and treat, though you should find a reputable plastic surgeon in your area to get the best results.”
Don’t stop living your life.
Having gynecomastia can be an isolating experience, so force yourself to not self-isolate. One of the most important things you can do for yourself if you have gyno is to simply keep living your life, even if it means working around your insecurities, Flores said.
After years of living with gyno, Tom had some tips.
“Besides just changing your attitude, you can do things to make it less noticeable,” he said. “In the summer I wear a lot of Hawaiian shirts. They’re loose fitting and have patterns that help to hide my chest. And I guess I am lucky that I have a really hairy chest; chest hair helps to really camouflage breasts if you take your shirt off.”
Continuing to live your life with gyno means you push yourself to go for a swim at the beach, with or without a shirt. It means going to the gym in whatever you feel most comfortable wearing.
And it means you can’t give up on your sex life. We live in the era of dad bod appreciation, where women fantasize about the late James Gandolfini and liken his “hairy chest” to an “inviting pillow.” Plenty of women ― and gay men ― are attracted to a little extra chest: “Please do not get surgery to remove your gynecomastia,“ one woman tweeted recently. “That shit is so HOT (Unless ur trans and it makes u feel bad).”
In other words, accept where you are now physically instead of letting your insecurities hold you back.
“I think by accepting the body we have today, it allows us to say, ‘I’m not going to hide anymore, I’m going to go to the pool,’” Flores said. “Whether you take your shirt off or not is inconsequential. What’s important is you telling yourself, ’I’m going to go on experiencing these things, and I’m not going to deny myself of them anymore.’”