Adrien Gleason looked in the mirror and saw no surprises.
Dressed casually in khaki shorts and rugby shirt, with a denim cap on his short blond hair—Adrien’s reflection fit his inner image of himself.
As a man.
And now, to his relief, that is how others see him, too.
No one expects him to wear dresses or makeup. Strangers don’t call him ma’am or young lady.
Adrien has made a transition he considers life-affirming—and lifesaving.
“I am proud of the person I have become,” he said. “I’m proud of the journey that I took to get here.”
The journey included transgender top surgery in July 2020. In the operation, Spectrum Health breast surgeon Amie Hop, MD, transformed his feminine chest into a masculine one.
But that was just the latest step in a journey that began as far back as Adrien can remember.
Trying to blend in
Although the world viewed him as a girl, that identity never fit for Adrien.
“My earliest memories go all the way back to my second birthday,” he said. “Even then, I felt like something was off.”
Throughout his childhood, he felt a disconnect between his identity and the trappings expected of girls.
He rejected all feminine clothes—and insisted on wearing T-shirts and jeans from the boy’s department.
In his teen years, he felt uncomfortable when people asked why he didn’t wear makeup or skirts. He avoided discussions about boyfriends or prom.
“I tried to blend in just a little bit,” he said. “But I always stuck out.”
At home, Adrien felt accepted and understood.
“I am extremely grateful to my entire family for embracing me for the way I was,” he said.
And he loved books and learning. School was a comfortable place, and he excelled academically. After graduating from high school, he went to Western Michigan University, where he is studying history and French.
But still, Adrien often felt alone, growing up as a gender-nonconforming person.
“It was hard to connect with other people because I felt I was telling a half-truth about who I was,” he said. “As a teen, my self-hatred was so strong.”
He struggled with anxiety and depression. He neglected his physical health.
Around age 22, he contemplated suicide.
“I didn’t see a future for myself that involved things other girls wanted, like children or getting married,” he said. “My mental health was so bad, I couldn’t see myself five years in the future.”
Researching online, he learned about others who had similar experiences. He recognized his feeling of disconnect as gender dysphoria.
He began to realize: “I know I am a man. That is how I see myself. I need to change my outside so people see that.”
Early one morning at college, he shared this revelation with his mom, in a text from his dorm room. He said he wanted to see a gender therapist and planned to transition from female to male.
“I just want to let you know who I am,” he said. “I am not a woman.”
His mom responded with love and support.
And that marked an emotional and uplifting turning point for Adrien.
“I got up to go to school, and I was a whole new person,” he said.
Starting the transition
Adrien’s mom, Emily Gleason, is a nurse at Spectrum Health. She helped connect Adrien with a Spectrum Health Family Medicine provider who is supportive of transgender patients.
She also sent him an article about Beau VanSolkema, a transgender man who shared his story of his surgery in 2018. Adrien identified with Beau’s emotional and physical journey.
“It was like a weight lifted off of my shoulders when I read Beau’s story,” he said.
In August 2019, Adrien received his first prescription for hormone therapy. His mom taught him how to give himself the testosterone injection.
As his features became more masculine, Adrien gained the confidence and self-esteem to focus on his mental and physical health.
He lost 50 pounds. He began treatment with a psychiatrist and therapist.
Although he feared rejection from his extended family when he began his transition, Adrien felt relieved to find support and understanding.
“I love that we have become more open as a society for people to be allies,” he said.
“Both sets of grandparents are accepting of me. That is such a privilege. So many people don’t have that kind of support network.”
In the summer of 2020, Adrien felt ready for the next step. He had never felt comfortable with his chest. And since he was 14, he had worn binders to minimize the appearance of his breasts.
He met with Dr. Hop to discuss his surgery.
‘Their confidence is amazing’
Dr. Hop, a surgeon with Spectrum Health’s Comprehensive Breast Center, began performing transgender top surgeries in 2019. She trained with G. Paul Wright, MD, the first surgeon at Spectrum Health to perform the surgeries.
Since then, Dr. Hop has performed more than 75 top surgeries. The program overall recently celebrated its 150th top surgery. The patients range in age from 18 to 65, with most in their late 20s or early 30s.
She has found it immensely rewarding to help transgender people through their transition.
“The patients are always so upbeat and so excited to be here,” she said. “And sometimes it is like you are seeing a different person afterward. Their confidence is amazing.”
Before undergoing surgery, patients receive counseling. Insurers that cover the operation require a letter of support from a mental health professional.
During a consultation with Adrien, Dr. Hop discussed the surgical techniques available and the approach that would work best for him.
“She showed me pictures of people who had surgery and helped me see realistic expectations for my body type,” Adrien said. “It was really nice to see so many people have gone through the experience.”
In late July 2020, Adrien underwent the four-hour surgery at Spectrum Health Butterworth Hospital. He went home the same day to recover at his mother’s house in Wyoming.
‘My puzzle is complete’
A couple weeks after the surgery, Adrien met with Kimberly Texley-Quigg, NP, a nurse practitioner who assists with the surgeries and provides post-operative care .
After Texley-Quigg removed the dressing on his chest, she invited Adrien to look in the mirror.
She typically does that with patients as they discuss their reactions to the results. Many are moved to tears.
The message she often hears is, “My puzzle is complete now. I feel I am who I am.”
And accompanying them through part of that journey, “is very gratifying. I am just blessed to be able to help Dr. Hop with these surgeries,” she said.
Sometimes patients come with a parent, partner or close friend who takes pictures and video.
Others tell her about rejection from their loved ones.
“We don’t realize a lot of transgender people have been through a lot of trauma in their journey,” Texley-Quigg said. “It’s a field where we have to express as much compassion and care as we can.”
That includes respecting a person’s gender identity, calling them by the name and pronouns they prefer.
As Adrien first glimpsed his transformation, he was pleased but quiet.
“It just felt really natural,” he said.
An advocate for others
In the months since his surgery, Adrien has embraced his identity as a transgender man.
“I feel very comfortable with my body now,” he said. “I’m able to wear what I want, and I don’t have to think about my chest now. I can do whatever any guy does.”
He has thrown himself into his studies—pursuing his passion for Medieval history and French language. He plans a career as an archivist.
And he hopes to advocate for transgender people and gender-affirming health care.
“The services through Spectrum Health that allowed me to start hormone therapy and to have surgery saved my life,” he said. “I genuinely would not be the person I am without my care team.
“The world needs to see more of the joy, freedom, and hope that transitioning gives people like me.”