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  • Writer's pictureVincent Pruis

Sistership and Top Surgery


I’m ten, and I’m in the backseat of the same car where I knocked out my little sister’s front tooth, and I’m screaming at her (again), and she’s screaming at me, and the hayfields out the open windows are screaming in the wind--a hish hish hish overridden by a windows-down-roar and the ferocity of angry children.

My mom slams on the breaks. She pulls as close to the ditch as she can on the shoulderless, unlined road and tells us to get. OUT!--we can walk the rest of the way home. And suddenly it’s only the hay hish hish, hushing us: a ten year old with a buzzcut and sneakers, and zir six-year-old little sister, barefoot on the asphalt.

Katie always takes her shoes off during car rides as a kid. And she doesn’t put them back on until we’re already parked. I hate it--daily, it makes us, every time, another thirty seconds late. Today, as usual, she hasn’t put her shoes back on. But this time we’re not waiting on her in the cool garage--we’re on the side of the road, alone together, our car disappearing into the heat-hazed driveway a country-block away.

Anger simmers in my lungs, lacing my short breaths. The breaths get longer as I stare at Katie’s bare feet on the road’s edge, though. I sigh, squat down, and gesture for her to climb on.

I carry her the third-of-a-mile home, legs aching like my scream-sore throat while her toes bob out in front of me, knees hooked at my sweaty elbows. I’m still angry--I am an impossibly angry kid, for years--but I promise myself, as I hold her, that no matter what, I will always carry my sister.


We’re not sure yet if the breast cancer my aunt has is the genetic type; all we know is that now there’s cases of breast cancer on both sides of our family. So, when I pray for my aunt, I also pray that--if it’s genetic--Katie won’t get it. I’ll take it instead.

In some ways, it’s a selfish deal.

My aunt moved in with my family after her diagnosis, so, on my summer break from college, our rooms are across the hall from each other, with my sister’s room kitty-corner. My aunt is tough and jarringly cheery all day long, but at night, I can hear her whimpering in her sleep. She has a double mastectomy.

In the grasshopper hum of evening, as I pray and listen to the post-surgery pain escaping her body, I’m steeped in a sickening envy. I’m praying that if anyone else in my family has to get cancer, it be me. Please be me. I don’t wish this pain on anyone else. But whenever I see a shirt flat over my aunt’s chest, I imagine doctors removing my breasts, too, without question, because they have to, and I’m angry that it wasn’t me who got cancer.

I don’t know yet that people can remove their breasts without the excuse of breast cancer, so as I pray that my aunt does not die, I tell God that, for me, it would be worth the risk.

Occasionally, my sister and I (being similarly “endowed”) talk about breast reduction surgeries. There’s no stigma around breast reductions, but I worry that for me, it wouldn’t be enough, that what I’d ask for would be unheard of. I know that sometimes trans women have breast augmentation surgeries. Yet, I’ve never heard of top surgery. Somehow, despite being an adult, a full twenty years old--and even though I know trans women exist--having never encountered a trans masculine person before, I don’t realize that they exist. That I could exist. That top surgery is an option, and maybe I don’t have to pray for death to survive.


I’ve followed Katie to Arizona. When she received her early admission letter to Embry Riddle Aeronautical University in Prescott, Arizona during my senior year of college, I applied to Northern Arizona University for grad school. So now, in the fall of 2020, we’re living an hour and a half away from each other--close enough for her to visit on the weekends, far enough that I’m still a sister to her, not a stalker.

On Halloween, she comes to my apartment in Flagstaff, and my parents join us too, for a four-person, quarantine costume party. My parents wind themselves up in toilet paper--mummies. Katie puts on fangs, a corset, and dramatic makeup--a vampire. And I borrow her eyeshadow to color a blue arrow down my forehead: I’m Aang from Avatar the Last Airbender. A cartoon character,--also, a prepubescent boy.

Katie takes photos of me on my balcony. We carve pumpkins, guts up to our elbows, then crowd my couch to watch a movie. That’s when I tell my family that I’ve made an appointment to start HRT.

In the evening, Katie offers me makeup wipes, and we stand in front of the mirror together, removing our faces. We talk about nothing. I want to ask her, sometimes, can you carry me?


Katie still calls me her “sister” sometimes, and I don’t mind that. So much of my identity is rooted in our relationship, and for all the discomfort I feel in being perceived as a “woman”--I find “sister” fitting. I can be transmasculine and a sister.

Tomorrow morning I have a meeting with a psychiatrist, and I’ll be asking her for a letter of referral for top surgery. In June, I have an appointment with my primary care physician to ask her for another. With those two letters, I’ll be able to schedule a consultation for top surgery.

Katie jokes that we should make it a sister’s activity--she’ll get a reduction when I get top surgery and we can recover together. I’m a little miffed that she could just decide to get a reduction, while I have to get two professionals to recommend me for a surgery. But I still smile. The anger I felt as a kid makes more sense now: I know where to direct it.

With so much in the world to rage against, I find respite with my sister, for, when needed, we carry each other.

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