May 22, 2013

Do I miss my breasts?

I had voluptuous breasts. I miss them, when I think about them. But I rarely think about them because I’m busy not missing my family’s milestones and ordinary moments. The kind of moments that I suspect Angelina Jolie does not want to miss.

Jolie and I have more in common than being mothers and having sexy husbands. I, too, carry the BRCA1 gene alteration, a mutation that raises a woman’s lifetime risk of ovarian cancer to 40-60 percent and breast cancer to 50-80 percent.

Almost 10 years ago I walked corridors like those Jolie recently navigated, though I waited until I was diagnosed with early stage breast cancer to have bilateral mastectomies and reconstruction. Jolie likened her breast reconstruction process with tissue expanders to “a scene out of a science-fiction film.” I described my process, in Self magazine, as an accelerated trip through puberty, except that my newbie breasts, growing over implanted tissue expanders being filled with saline, felt disembodied, like a Dr. Seussian Thing One and Thing Two.

All things considered, the cosmetic result was fine. But — and this is one area (though hardly the only one) in which Jolie and I differ — Jolie writes that she does “not feel any less of a woman” and the change “in no way diminishes” her femininity. I do feel as strong a woman as ever and, as a guy I cycle with said, I clean up good.

But I feel a little deficient in the femininity department. Of course, Jolie did have a big head start, what with being a sex goddess and the idealization of beauty. But even if (OK, this is a big stretch) I had a tiny bit of that sex goddess thing going on, I’d probably still feel a little fraudulent with my implants. Perhaps that’s because I grew up in the ’60s and ’70s when “natural” was the byword and the cool older girls not only eschewed padded bras, they eschewed bras entirely. Nothing artificial. It must be some cosmic joke that with my permanently perky implant-filled breasts, I’m a shoo-in, but only sort of, to the cool-girl braless party.

Sure, sometimes I feel a twinge when I come across photos that caught my formerly fabulous cleavage. But I traded my breasts for my life, and that was no booby prize. And, as much as I miss my estrogen (yes, you’ll need to remind me several times of your name), I also have no regrets about having had my ovaries removed prophylactically in my late 30s.

That a few readers of Jolie’s New York Times op-ed posted comments criticizing her choice flabbergasts me. Some suggested that Jolie should have waited to see if she developed cancer or implied that she might have regrets if preventive treatment for the gene mutation is discovered in the next 10 years. How can anyone question Jolie’s reality, her risks, and the decision she made for her children, her partner, her extended family, and herself? Anyone who made such comments probably hasn’t watched his or her mother succumb to ovarian cancer, as Jolie watched her mother and I watched mine.

When I was a teenager, I gagged as I rubbed my mother’s back while she vomited from chemotherapy. I cried silently, unbelieving, as I watched my extraordinary and beautiful mother lose her vigor, independence, and, at 48, her life. Where experiences should have been shared with her and memories made, there was empty space.

If I were just learning my gene status now, I would opt for prophylactic mastectomies rather than the close monitoring alternative, particularly because advances in surgery can provide a better cosmetic result and more options than existed a decade ago.

I have been adviser, mentor, and friend to a number of women undergoing mastectomies. To meet each of these women, I dress carefully, body-consciously, showing a bit of skin or even cleavage, if that’s what I can call it now. I apply blush and mascara. I want to look attractive and robust. Confident in my body. I want my demeanor to say, “You will be OK, you can go where I have gone.” I want each of the women to see a whole woman when they look at me.

Sometimes one of these women asks questions I’ve pondered. What constitutes womanhood? Anatomy? Hormones? Chromosomes? The sway of the hips? I don’t have an answer. I just know that I don’t need breasts to be a mother, or a wife, a daughter, a sister, a friend. I don’t need breasts to celebrate my daughter’s neurology class grade or my son’s landing his first job, to bicycle 400 miles with 38,000 feet of climbing in six days, to share a belly-aching laugh, to whip up a mean pesto. I can’t think of anything I need breasts to accomplish. Do I need breasts to feel like a real woman?

Probably not. And if I’m not sure, there’s a sex goddess I can ask.