DD wants to have surgery

[LittleThings]

... . to remove her breasts. She's 19. According to her, this is something she said she's been thinking about for a year.

She says she is queer, meaning she is in the spectrum of gay, but doesn't identify w/either sex necessarily and that it can be fluid. But the breasts need to go according to her. I think she's been reading alot on the internet about this.

The way she presented this was with me alone on the couch, she came and sat down. We chatted briefly and then she said, "did you know insurance has to cover surgery for people with body dysphoria?" What ensued was a conversation that was generally ok, but did get a bit heated. She seemed to want to feel me out about her "decision".

I said I was concerned that she was so young and wanted to make such a big decision, and that she is in the midst of many other issues, i.e. MDD, BPD, and a host of other ever changing behaviors, like cutting, smoking pot, not working, staying in bed all day, running out of money... . basically not being an adult, that may make this decision not the best one. She has made some positive decisions lately and we are thankful for that and have acknowledged them.

I also said that it concerned me that she wanted to change things on the external to try to fix things that are internal.

She, of course pushed back that it's part of improving her mental health... . but in our eyes she hasn't really done the "work" long enough. It seems like she's looking for a quick fix.

She said, my therapist backs me up on this! OK, fine. Maybe she's giving my DD false hope, because I don't believe there is any way that medicaid (her insurance) would pay for this type of surgery. That in and of itself would possibly be the deciding factor here.

One of the last things I said was that I cannot tell her what to do with her body, but that it seemed like she needed me to accept this idea. Her response was, "well I would need you to take care of me after surgery."

I can't even process this information, since there has been so much else that's come down the pike in the last 10 months. You all know what that's like

Is this part of the identity issues that go w/BPD? I wonder if anyone has any insight here.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[jellibeans]

Dear littlethings

I see a lot of positives things from your post... . 1) you were able to have a good conversation with her 2) She came to you for advise... . I see that as a plus. I have no experience with this but I do have a dd16. What I know is that my dd16 always has a grand plan to do something... . I have learned that this plan often changes several times and then in the end it doesn't happen. I have learned to take a wait and see approach... . often my dd changes her mind or what she proposed is just not possible. I do not think it would be easy to get this kind of an operation... . I would think it might take several years and even then the chances are slight.

I think you handled it great and I like the points you made to her about working on the inside first!

[LittleThings]

Thank you jellibeans. Your posts are always so helpful and encouraging

I am glad she shared it with me.

You are so right about the grand plans, and wait and see. This isn't the first time we've heard some eyebrow raising ideas that never come to fruition.

I always wonder what they really think our response will be when they present them to us.

[Eclaire5]

I think sometimes they just want to push our buttons. They come up with the oddest ideas and have all the intention to follow them through, but at the end they forget about them. So, try not to worry too much. First of all, it would be unlikely that her insurance would cover such a major procedure just because she wants to. When my daughter comes up with odd ideas, I just listen and try to be understanding. I don’t even argue or try to convince her to do something different because it usually goes nowhere. Sometimes I might say, “Well, if I was in your place I would do such and such…”, but that’s the farthest I will go.

[peaceplease]

Little Things,


I think that you responded really well. 

Do you believe that her therapist is truly supportive of this?  Or, possibly, your dd percieves that her therapists backs her up opn this.  Or, then maybe, she does support her?  I know that I always wonder what my dd tells me about what her therapist or case manager said.  I wonder if my dd is telling me the truth.  With her case manager, I am not so surprised, as she has crossed the line of being professional, and became a friend of my dd's. 

And, I would bet my last dollar that any insurance would  not pay for it, and especially medicare/medicaid, unless there is a medical reason. 

Again, you handled it really well!

[RunningWithScissors]

Little Things -

My BPD step son expressed many of those thoughts when he was 14-15 years old.  He's actually FTM (female to male) transgender, a journey that we've supported him on.  At the beginning he simply 'presented' as male with short haircuts, masculine clothing and using binders to conceal his breasts.  Now, he's over 18 and is on hormone therapy. 

I don't know if body dysmorphia is linked to BPD but this is something that he has to decide for himself as it's a huge committment.  My step son has actually been willing to admit that he's not sure if this is the path he wants largely in part because he knows we're completely neutral in our opinions.  If I could speculate, based on what I've been learning about BPD, I wonder if the unhappiness that BPD people experience would lead them to think that 'if I'm unhappy as a girl, maybe I'll be happier as a boy'. 

Sounds like you did an awesome job handling this situation.  Yay!

[LittleThings]

I'm not sure if her therapist really backs her up on this, or if it's more not worrying about it too much at this point. Maybe her therapist recognizes that our DD has far to go... . and if this gives a glimmer of hope let it be... . ?

DD had said about the pot smoking, "my therapist doesn't think it's a big deal." Later we came to find out that what she actually said was it was not her biggest concern at that point. (suicidal ideation and

cutting was) She may not have been too worried about it then, but I'm sure she didn't think smoking pot was a good idea.

It's no wonder we doubt the therapists sometimes... . from what our BPD loved ones tell us, they seem to say things that undermine us at times :/

She saw a new psychiatrist 2 days ago who has made a diagnosis of Bipolar II with BPD most likely. She is trying to get my DDs meds figured out before going much farther.

She's now on Lithium, Cymbalta and Abilify.

Not sure how we will feel if DD did go through with this, but a mentally ill person does not seem like the perfect candidate for this type of surgery.

Scissors, we did touch on the fact that she has not been happy and that a surgery wouldn't necessarily fix anything.

My DD sees me as more PC than my DH, so I am always the one who has the pleasure of hearing the latest idea. I do often want to run screaming from the room with my fingers in my ears... . "lalalala, not listening!"... . but I don't. I sit there as a sounding board, sometimes feeling my body start to tremor a bit from the stress.

I come from a dysfunctional family, so I know that I crave normality... .

[yogablue]

I too think you handled it really well, Little Things, good for you!  Some of the ideas BPD children come up with are down-right ludicrous sometimes.  I know my dd often tells me things she thinks I want to hear (where do the lies begin and the truth end?... . )

My dd22yo has told me for years that she has something wrong with her breasts.  She's showed me photos of the condition and when I've gently suggested she shows me she refuses.  She told me recently she 'needs' to have an operation on them, reasons are she may not be able to breast-feed etc.  I have no idea whether this is real or not.

She's had two bf's and when I suggest they didn't seem to have a problem with her physically, she says 'it's not about them, it's about me'.  So difficult to figure out, isn't it?  It's basically regarded as cosmetic surgery, I'd think (although your dd's desired surgery is more radical) and I don't think any medical aid would cover it which probably means it ends right there.

Likewise my dd has the idea she will move to a city 1,000km way (in Australia) because she met a friend last year who moved back there.  Her friend's mother will take care of my dd etc etc. but I personally think it's all pie in the sky stuff.  This was my dd's solution when she recently broke up with her bf.  Avoidance, running away comes to mind as my dd will just have the same problems in another city the way I see it... .   Very sad, I sympathise with you.