boys with breasts
by Bruce Tober
Little can dent the self-confidence of many teenage girls more than being flat chested. Why else would so many women admit to having stuffed their teenage bras with tissue or socks to swell a less than ample bosom? However many of their counterparts, teenage males, are faced with the opposite problem – one that is often more embarrassing and psychologically damaging than concern over the size of their genitals. That problem is having unusually large breasts.
"Yes," says Dr. Elliot Jacobs, a New York plastic surgeon who has suffered from the condition – known as gynaecomastia – since his teens, "women with flat chests are embarrassed and feel unfeminine – men with gynaecomastia feel embarrassed and feminized."
© C4
Unfortunately, pejorative definitions, such as that of the American Heritage Dictionary of the English Language, 2000, don't help. That highly respected US dictionary defines gynaecomastia as "Abnormal enlargement of the breasts in a male." (My emphasis).
On the other hand, the Oxford English Dictionary, 1999, is less likely to cause the sufferer concern about being abnormal or a freak. It describes gynaecomastia as "the condition of a man's breasts in which they are as large as a woman's and functionally active."
wide-ranging numbers
Gynaecomastia is thought to affect up to 60 per cent of men at some point in their lives. It generally begins (and most often ends) during their most emotionally-vulnerable time of life, their teens. Incidence rises dramatically from about 2 per cent of 11-years-olds to a peak of about 60 per cent of 15-year-olds and then plummets again to affect around 20 per cent of 17-year-olds. In adulthood the number of men with the condition rises slowly to reach a second peak around the age of 60.
Gynaecomastia is caused by a "hormonal imbalance with an alteration in the ration of testosterone to oestrogen in the body," according to Dr Rick Silverman, a plastic surgeon in Boston, USA. The imbalance is that "the oestrogen is high, thereby stimulating receptors in the breast tissue in individuals with susceptibility to this," he says. "Hormonal therapy may prevent the condition in cases where an inciting cause can be identified early," Silverman explains, "but generally, the diagnosis is made after the fact. By then it's too late for hormonal therapy to have any impact."
In London, Dr Chris Inglefield mostly agrees with that assessment. He says, "the cause is oestrogen stimulation resulting in breast development. This occurs naturally in puberty but can occur as a result of drugs (side effects) and tumours, especially testicular cancer." However, he thinks neither "hormone nor other treatments... reduce the size of the breasts."
a major adolescent problem
Typical emotional traumas faced by adolescent boys are caused by everything from spotty faces, to bodies with more fat than muscle, and not least by their opinion of the size of their genitals in compared with those of their mates. Such problems are potentially devastating and can carry over throughout their adult lives, seriously affecting their physical and emotional well being, and even their intimate relationships as this author knows only too well.
Back when I was a teenager, we had no idea. We had no internet to use to find out what our boobs were all about. All I knew was that our housekeeper told me at age 10 or 11, "you have boobs just like a girl". Now that's something a kid doesn't talk to dad about.
Fortunately this was the mid-1950s and women, including my mum, were wearing stretchy, wide elastic belts with their skirts. I stole one from my mother and 'bound' my boobs with it. Of course I still had to wear loose fitting shirts to hide the bulges caused by the belt, above and below it, but at least those slight bulges looked nothing like 'boobs'.
"Most men are unaware of what is 'wrong' with them and are unaware of how easily surgery can correct the problem," explains Dr Robert Hamas, a cosmetic surgery specialist from Texas, USA. "The internet has opened the doors for many men who now are happy to learn all about what has caused them such emotional pain for so long."
education is important, but missing
Inglefield expands on this theme, noting, "Education and support are very important. In puberty, boys need support and reassurance that they are not strange or freaks and [that in most cases the symptoms will] resolve by the end of puberty. In adults it is important that these individuals have an examination to rule out the possibility of breast development being caused by drugs or tumours."
"Regrettably," Silverman finds, "many young men are not aware of what their condition is, and they feel embarrassment or get teased in a way that they feel responsible for it. Because 95% of patients who get gynaecomastia will resolve on their own, many paediatricians advise against early intervention, believing that it may go away." He thinks this a reasonable approach but that it "doesn't compensate for the psychological issues at a time when young men are particularly vulnerable to sexual insult and teasing by peers."
Rather than just ignoring the condition, he suggests doctors should "perhaps [advise] teens specifically that they have a common condition that almost always resolves within two to three years, and that they should consider surgical intervention if it doesn't resolve – thereby setting a time line – they might handle the problem better, and parents could better support them through it."
Silverman says such advice isn't more frequently provided because, "many paediatricians don't assign much significance to this 'cosmetic' disease, and insurers (at least in the US) are willing to pay for fewer and fewer procedures."
hiding the problem?
So how do sufferers handle the condition? According to Inglefield, many teens and older men put on weight in order to disguise the condition as one of being fat. "I do not believe that this condition can be hidden away by fat," he says. "Most men have been through this cycle of weight gain and loss to change their breast but with no effect."
Hamas says, "men usually hide the breast prominence under baggy clothing... If it can't be hidden well, they tend to avoid social situations where it would cause embarrassment, such as swimming pools and locker rooms."
And true to form, I did all those.
But I got stick from the other boys anyway because no method of trying to hide the "lumps" is truly successful. And I thought I noticed a few girls looking at me "funny" and so became shy around them.
And so, as in Hamas' example, I avoided PE classes as often as possible; I stalled getting into the shower till the other kids were gone. I avoided the beach and I never went without a shirt or at least a t-shirt.
Asked why the range of estimated numbers of men suffering from gynaecomastia is so broad, Silverman says it's "because the definition [of gynaecomastia] varies and the method of surveying varies." "Defining gynaecomastia as any mass or lump is different from saying that the breast must actually look 'female' in nature," he continued. "Some surveys might look at the absolute number of individuals who develop any symptom (lump, pain, fullness) versus full-blown condition. The higher numbers will come from the more inclusive surveys."
enjoying the benefits
So is there a positive to men "suffering" from gynaecomastia?
Well in my own experience, I find, or rather my wives and lovers have found, my breasts to be very erotically sensitive. However, Inglefield says there is "no evidence that the breasts are more sensitive than normal."
And Silverman agrees, noting that he is not aware of evidence of such increased sensitivity. "In general, because women are not very attentive to men's breasts during sexual activity, most heterosexual men are not terribly attuned to nipple sensitivity. In my practice, a few men have expressed concern over nipple sensitivity, and these have generally been gay men, where 'nipple play' is a more significant part of the sexual repertoire."
Gay or not, that's one benefit I wouldn't want to lose.
help and info
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organisations
Klinefelter Organisation (KO)
234 Turton Road
Bolton BL2 3EE
E-mail: ko.info@talk21.com
Website: www.klinefelter.org.uk
Gynaecomastia is one of the possible physical effects of Klinefelter Syndrome, a genetic disorder where men are born with at least one extra X chromosome. KO is a membership organisation that provides support to people with Klinefelters and their families, and aims to raise awareness of the condition within the medical profession.
Klinefelter Syndrome Association UK
56 Little Yeldham Road
Little Yeldham
Halstead CO9 4QT
Tel: 0845 230 0047 (no later than 10pm)
E-mail: adults@ksa-uk.co.uk
Website: www.ksa-uk.co.uk
Offers support and information to adults and their partners as well as children and their families who have Klinefelter Syndrome and its variants.
Pituitary Foundation
PO Box 1944
Bristol BS99 2UB
Helpline: 0845 450 0375 (Mon-Fri 9am-5pm)
E-mail: helpline@pituitary.org.uk
Website: www.pituitary.org.uk
Provides information and support to those with pituitary disorders, their relatives, friends and carers. The helpline number can put callers in touch with a 'telephone buddy'. The buddy will be a patient, carer or professional who will give information, advice and support, and be available for the caller to speak to again should they need to. Also provides details of local support groups.
enquiring about surgery:
British Association of Aesthetic Plastic Surgeons (BAAPS)
at The Royal College of Surgeons of England
35-43 Lincoln's Inn Fields
London WC2A 3PE
Advice Line: 020 7405 2234
E-mail: info@baaps.org.uk
Website: www.baaps.org.uk
Offers information about aesthetic plastic surgery. The website features a search facility for accredited surgeons.
General Medical Council
Regent's Place
350 Euston Road
London NW1 3JN
Tel: 0845 357 8001
E-mail: gmc@gmc-uk.org
Website: www.gmc-uk.org
Maintains the Specialist Register of Plastic Surgeons. The registration department can provide information on specific doctors and their fitness to practise, free of charge. Contact them to check if the surgeon you have chosen is on their register.
websites
Breasts in Men
www.embarrassingproblems.com/breasts_g.htm
Article looking at the various causes of breast development in boys and men.
Bullying
www.childline.org.uk/bullying.asp
Lots of information on how to stop bullying and where to get help.
Canada Press: Teen Boys Increasingly Struggling with Gynecomastia
http://mediresource.sympatico.ca/channel_health_news_detail.asp?channel_id=158&menu_item_id=0&news_id=2643
Article from November 2003 looking at the high number of teenage boys that feel humiliation and shame as they develop breasts through puberty.
Gynecomastia.org
www.gynecomastia.org
Popular American site with lots of useful info, medical articles, FAQs, treatment options and much more. Set up by Merle Yost – an American psychotherapist who developed breasts as an adolescent and went on to have them removed surgically.
Gynaecomastia (development of breasts in males)
www.bupa.co.uk/health_information/asp/healthy_living/children/gynaecomastia/
BUPA site that looks at what causes this to happen, how to cope with embarrassment and what can be done about it.
Enell Male Support Vest
www.enell.com/formen.html
A US-based company, Enell Inc, carries a Male Support Vest for men with gynaecomastia or related conditions. The Custom Order department works closely with customers to insure a proper fit and they will make every effort to do so with the utmost discretion and confidentiality. You can contact Enell by e-mail at info@enell.com or by telephoning 001-406-265-8250.
Milkmen: Fathers who Breastfeed
http://laurashanley.com/milkmen.htm
Argues that contrary to popular belief, men are able to breastfeed their children.
The Nursing Father
www.unhinderedliving.com/nursingfather.html
A second article looking at fathers who breastfeed, including biblical references to the practice.
Student Health
www.studenthealth.co.uk/leaflets/Gynaecomastia.htm
Brief discussion of some of the causes of gynaecomastia.
reading
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Breast Disease in Women and Men: A Clinician's handbook by Pamela A Schuler (Essential Medical Information Systems, 1993) |
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Gynecomastia – A Medical Dictionary, Bibliography and Annotated Research Guide to Internet References (Icon Health Publications, March 2004) |
Breast Deformities and Their Repair by Jacques W Maliniac (Grune and Stratton, 1950) |
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(August 2004, resources updated February 2005)
