While cisgender aging men face a delegitimisation of their masculinity as a result of ageist, ableist and heterosexist tropes associating ‘real masculinity’ with virility, ability and youth, this phenomenon takes a particular toll on middle-aged and older trans men. Founded on an autoethnographic methodology, this chapter focuses on my desire for a top surgery (mastectomy) resulting from bodily changes associated with ageing, as well as structural factors such as cisgenderism and ageism. To do so, I first point to some limitations in the literature on trans ageing. Second, based on an autoethnographic account anchored in my experience as a trans middle-aged man, I provide personal narratives that can help healthcare professionals better comprehend the complex intersections of transness and ageing and cisgenderism and ageism. Third, I insist on the importance, for academics and practitioners, of endorsing an intersectional approach to better serve marginalised populations living at the intersection of multiple oppressions.
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