\n<\/p>\n
Grace is the senior content editor for Hop Culture<\/a> and Untappd<\/a>, writing stories and curating content on the diverse voices in craft beer across the globe. She has also organized and produced the largest weeklong festival in the country for women, femme-identifying, and non-binary people in craft beer, Beers With(out) Beards, and the first-ever festival celebrating the colorful, vibrant voices in the queer community in craft beer, Queer Beer. Her favorite accompaniment to drinking beer is reading an Agatha Christie or Louise Penny novel while watching a British crime show.<\/em><\/p>\n I laid on my back, the sheets around me damp as a beer cellar. Tubes stuck out of my chest, a throbbing nuisance, like living above a nightclub. For two weeks, I\u2019d been confined to my bed, sometimes knocked out by painkillers, barely able to move. I couldn\u2019t work or even go to the bathroom by myself.<\/p>\n When you get top surgery, you don\u2019t wake up with a new body; you grow into one.<\/p>\n A form of gender-affirming care, top surgery involves removing breast tissue and sometimes reshaping the nipples, creating a more masculine appearance.<\/p>\n Gender dysphoria is a medically recognized deep unease that occurs when your biological sex doesn\u2019t match your gender identity. For someone experiencing it, top surgery or other gender-affirming care can make all the difference, helping transgender and nonbinary people feel more confident in their own bodies.<\/p>\n Lex Laughman, head brewer at Goldspot Brewing<\/a> in Denver, Colorado, describes top surgery as \u201ca life-saving medical treatment I\u2019ve wanted for a long f**king time.\u201d<\/p>\n But the path to top surgery, especially in the beer industry, is challenging. The average recovery is typically three to six weeks minimum, requiring severely limited physical activity.<\/p>\n Plus, with costs running upwards of $10,000 in the U.S., hourly workers without benefits, like most bartenders and brewers, find it difficult to pay for top surgery, much less take time off without fear of losing their jobs.<\/p>\n Grayson Alexander, a trans man working for the last three years in malt production and bartending at Admiral Malting<\/a> and the maltster\u2019s pub, The Rake, has known since 2019 that he wanted top surgery. But he found getting treatment difficult.<\/p>\n \u201cThere just isn\u2019t access to care,\u201d he says.<\/p>\n As a writer with a supportive partner, I had the luxury of taking time off to recover. But I can\u2019t imagine having to lift 55-lb. grain bags, move kegs, or pour beer for customers soon after surgery.<\/p>\n More importantly, it\u2019s difficult to consider navigating gender-affirming care in a predominantly cis-hetero-male environment.<\/p>\n When you work in the taproom, you don\u2019t just get gender-affirming care or top surgery, wake up the next day, and go right back to work; you fight to be your authentic self and survive.<\/p>\n Gender-affirming care, including top surgery, is life-saving.<\/p>\n Think about waking up every day inside a body that feels foreign to you. It would be like walking into a room where everyone speaks a language you don\u2019t know: They feel comfortable. You don\u2019t.<\/p>\n Gender-affirming care can completely change a person\u2019s view of their body\u2014mentally, emotionally, and <\/em>physically.<\/p>\n I\u2019ve known from a young age that I felt strange in my cis-female body (cis meaning the gender identity that matches your sex assigned at birth).<\/p>\n Growing up in the 90s, I got by wearing more \u201cmasculine\u201d clothes; after college, I coped by cutting my hair short. These strategies helped, but I still felt a disconnect between the body I wanted and the one I woke up with daily.<\/p>\n A week after my top surgery, when the doctor removed my bandages, I looked at my body in the mirror and cried. For the first time in my life, everything finally matched.<\/p>\n I\u2019m 35 years old, and while I\u2019m still exploring my gender identity, I needed three decades to feel safe enough to live in a body that felt natural. And I don\u2019t even work in a brewery every day.<\/p>\n Beer is a predominantly straight-cis-male industry. A 2021 audit by the Brewers Association found only 0.2% of brewery owners identifying as non-binary or third gender, with 75.6% reporting as male.<\/p>\n Identifying as non-binary, Laughman couldn\u2019t name anyone else gender nonconforming or trans at a brewery. That\u2019s not to say trans and non-binary people in beer don\u2019t exist, but they are a minority and might not always feel comfortable being out and visible. \u201cI think that\u2019s part of the problem,\u201d they said.<\/p>\n Although Laughman, 35, has been taking testosterone (T) for two years, they knew they wanted top surgery since they were 19. But at previous breweries, Laughman couldn\u2019t find the safety or support they needed, such as supportive management, appropriate paid time off, or medical insurance.<\/p>\n Similarly, top surgery has remained out of reach for Alexander, who started transitioning and taking T in 2019.<\/p>\n Currently, he binds, which involves flattening one\u2019s chest using tight-fitting clothing.<\/p>\n \u201cWhen you\u2019re raking grain all day, you don\u2019t really want to talk to your cis coworkers about how your underboob sweat is bothering you,\u201d says Alexander.<\/p>\n It\u2019s also why he carefully chooses who to talk to about his transition.<\/p>\n While some coworkers support him, others fall short. When you mix ignorance with beer and social situations, \u201cthey\u2019re asking some really weird, invasive questions,\u201d he says, like, \u201cWait, you mean to tell me you have a f**king p**sy? If you asked any one of your cis coworkers about their genitalia, that would be considered sexual harassment.\u201d<\/p>\n Another trans man, who works for a big brewery and wishes to remain anonymous, says when people learned he was trans, they intrusively pried. Often it occurred after a few beers, \u201cwhen people get tipsy and confident,\u201d he says.<\/p>\n This trans man, who got top surgery when he was 20 and has taken T for the last seven years, worries. When he goes out drinking with his colleagues\u2014predominantly straight cis-men\u2014he has to endure homophobic and misogynistic jokes. \u201cI\u2019m not so sure anybody would stick up and take my side,\u201d he shares. \u201cIt\u2019s the ganging up on you that makes it scary.\u201d<\/p>\n According to Sarah M. Brown, clinical associate professor of law at Northwestern Pritzker School of Law, who has spent 15 years working in employment discrimination, these instances can qualify as sexual harassment, but they\u2019ve been historically hard to litigate.<\/p>\n \u201cIt\u2019s comments, things that seem like jokes, dead naming someone [using the name a transgender or non-binary person was given before their transition], misgendering someone purposefully\u2026that build up over time and eventually create a workspace where you are just uncomfortable and don\u2019t want to go to work,\u201d she says. \u201cThe question then becomes, is it a hostile work environment?\u201d<\/p>\n Brown says since a landmark 2020 Supreme Court Case Bostock v. Clayton County<\/em><\/a>, which federally extended discrimination outlined in Title VII of the Civil Rights Act of 1964 to sexual orientation and gender identity, the answer legally has more often been yes.<\/p>\n But it\u2019s complicated.<\/p>\n On a basic level, you need to prove that these comments or jokes have accumulated over time. \u201cPervasive,\u201d says Brown. \u201cThat\u2019s the word that the courts use.\u201d<\/p>\n That means reporting each instance of abuse, which for someone who identifies as trans, non-binary, or gender nonconforming and potentially isn\u2019t out to everyone at work, can be very difficult.<\/p>\n \u201cThat\u2019s the tricky thing,\u201d says Brown, who says she has seen sexual harassment cases at their worst in the hospitality industry. \u201cYou need to find a way to put your employer on notice, but if you don\u2019t say anything, if you don\u2019t essentially out yourself or make the complaint known, then I think the idea is we don\u2019t expect employers to be omniscient. We expect them to train people. We expect them to do what they can to create a good workspace, but we can\u2019t expect them to know about things if nobody tells them what\u2019s happening.\u201d<\/p>\n One measure Brown suggests for companies that want to create a safe workspace is to set up an anonymous reporting system. \u201cAn anonymous complaint counts as a complaint,\u201d she says, because, at the end of the day, \u201cyou\u2019ve got to engage in order to get some resolution.\u201d<\/p>\n But that is often the last thing on someone\u2019s mind when they\u2019re already contemplating how to deal with getting top surgery in the beer industry.<\/p>\n Alexander hopes to get top surgery next year, but that decision has meant potentially leaving the beer industry.\u00a0<\/p>\n \u201cWhat are you going to do? Go to your manager and be like, \u2018I really want to stay here, but there\u2019s nothing that\u2019s going to help me attain my goal of getting surgery?\u2019\u201d he says.<\/p>\n Top surgery isn\u2019t simple. It requires capital and time off to recuperate.<\/p>\n \u201cIt\u2019s not a vacation,\u201d Laughman says. \u201cIt\u2019s not just an easy two-day recovery, and you\u2019re done. This is a commitment of time, effort, pain, suffering, and struggle.\u201d<\/p>\n The Gender Confirmation Center<\/a> (GCC), a clinic specializing in gender-affirming care in San Francisco, California (where I had my top surgery), recommends at least six weeks of rest before resuming strenuous physical activity. Most patients take one to two weeks off work, especially since lifting and movement are restricted.<\/p>\n For the first three days post-op, I could barely get out of bed. On day four, when I walked down the hall, I felt like pumping my fist in the air. But I physically couldn\u2019t. My surgeon restricted lifting anything over 10 pounds for a week, but I couldn\u2019t even put my arms above my head until a month later.<\/p>\n What surprised me the most was how drained I felt. After a week, my surgeon said I could start walking for up to 15 minutes. On my first attempt, I barely made it a block before I had to go home and take a nap.<\/p>\n As Goldspot\u2019s head brewer, Laughman spends their entire day on their feet. \u201cRunning up and down the brew deck, picking up hoses, it\u2019s very physical,\u201d they said. \u201cI\u2019m moving up to 15 kegs into the brewhouse, filling them manually, and moving them into the cold room by hand.\u201d For perspective, a full half-barrel or sixtel keg typically weighs around 168 and 90 pounds, respectively.<\/p>\n Laughman will need to fully recover after their top surgery before even considering returning to the brewery.<\/p>\n Currently a bartender, Alexander also has concerns.<\/p>\n \u201cPouring beer seems simple,\u201d he says, \u201cbut when you think of top surgery and the tubes or drains getting caught or pulling out your sutures \u2026 it\u2019s not as easy as you think.\u201d<\/p>\n Drains are tubes placed into the side of your chest with bulbs on the end that collect excess fluid to prevent infection. They\u2019re slightly bulky and uncomfortable to wear in public.<\/p>\n Another trans man I spoke with, who worked part-time as a bartender when he had top surgery, took three months off after a complication.<\/p>\n \u201cNo way I could bartend,\u201d he recalls. Even when he returned, his doctor told him not to move kegs. \u201cI would ask someone to do the heavy work, so I was just mainly behind the bar,\u201d he explains.<\/p>\n According to Brown, the Americans with Disabilities Act (ADA), a federal civil rights law protecting people with disabilities from discrimination, could actually apply here.<\/p>\n \u201cWhen you come back to work, you\u2019re entitled to accommodations under the ADA,\u201d she says, noting the federal law applies to any company with more than 15 employees. \u201cIf you\u2019re a bartender, something like a lifting restriction could come into play with top or bottom surgery where accommodations could be made in the workplace.\u201d<\/p>\n She says it\u2019s just a matter of going to your employer and starting a conversation. \u201cThere\u2019s no magical words,\u201d she explains. You just say, \u201cI\u2019m having a medical issue. I\u2019m entitled to accommodations under the ADA. I\u2019d like to start having a conversation with you about what I need.\u201d<\/p>\n Often that \u201cinteractive process\u201d\u2014in legalese\u2014will involve your doctor, who can give recommendations on your restrictions that don\u2019t interfere with your essential functions. \u201cIf you\u2019re a bartender and you can\u2019t serve drinks, that\u2019s not an accommodation,\u201d explains Brown. \u201cBut if you\u2019re talking about ancillary duties, like how often you carry cases upstairs, the employer is supposed to help you find a way to keep your job and assign you different things that are not physically taxing.\u201d<\/p>\n No one I talked to even mentioned the ADA, and I personally knew nothing about it before speaking with Brown. \u201cI don\u2019t think many people know their rights,\u201d she reminded me.<\/p>\n Beyond dealing with the physical limitations and your understanding of your legal rights, though, Alexander adds that hourly employees rarely get full-time benefits, making it challenging to disappear for long stretches. \u201cThere is no way I could afford to take that much time off.\u201d<\/p>\n Laughman agrees, noting part-time gigs won\u2019t support your recovery. \u201cThey\u2019re going to hire somebody who\u2019s going to take your job,\u2019\u2019 they said. Looking back, Laughman says they would have needed to use the Family and Medical Leave Act (FMLA) \u201cbecause I\u2019ve never had enough PTO to take off weeks at a time.\u201d<\/p>\n FMLA entitles an employee to protected time away from work for certain circumstances, such as a serious health condition. However, the law doesn\u2019t clearly cover gender-affirming care.<\/p>\n \u201cPatients who are candidates for FMLA are usually dependent on their employer and how long they\u2019ve been there,\u201d explains Jaan Jaime, a medical assistant at the GCC who helps patients navigate these questions daily. \u201cIf they are not there for a long enough time or if they are part-time, unfortunately, they don\u2019t qualify.\u201d<\/p>\n Jaime explains he frequently sees patients use PTO or sick time for top surgery, which is \u201ctricky because if you only have 40 hours of both combined, that\u2019s technically only one week,\u201d he says, noting that\u2019s often not enough time for recovery.<\/p>\n That\u2019s why Alexander decided to go back to school. He plans to cut hours at The Rake to qualify for Medi-Cal, California\u2019s Medicaid healthcare program, which can help pay for his surgery.<\/p>\n \u201cIt finally got to the point where I couldn\u2019t do it anymore,\u201d he shared. \u201cI want to go enjoy life.\u201d<\/p>\n Alexander wishes people would acknowledge the complexities of gender-affirming care. He hopes managers and coworkers can create safer, more inclusive environments.<\/p>\n \u201cIt says a lot that we don\u2019t feel like we can \u00a0say, \u2018I\u2019m really struggling, and I\u2019m going to need to take time off,\u2019\u201d he says.\u00a0<\/p>\n When I asked Courtney Simmons, former diversity, equity, and inclusion director at Bell\u2019s Brewery<\/a> and New Belgium Brewery<\/a> and founder of the Inclusive Insight Group<\/a>, how breweries and bars can support employees interested in gender-affirming care, she went back to basic DEI principles. Employers must create a workplace where staff can speak up for their medical needs.<\/p>\n \u201cCan I say, \u2018Hey, I don\u2019t feel like I\u2019m in the body I\u2019m meant to have, and I want to get surgery\u2019?\u201d she asks. \u201c\u2018Ideally, you\u2019d help pay for that surgery, but if you can\u2019t, I need to be able to take time off.\u2019\u201d<\/p>\n Simmons adds that businesses benefit when employees feel safe and supported. If a rising tide lifts all ships, when you provide opportunities for underrepresented communities\u2014like trans, non-binary, or gender nonconforming people\u2014everyone benefits.<\/p>\n \u201cAll organizations, especially in beer, have an opportunity to be intentional about how their benefits care for their humans. Full stop,\u201d says Simmons. \u201cWhether you need support and care because you are not in the body that you\u2019re meant to be in or because life is just really f**king hard.\u201d<\/p>\n A little over a year ago, Laughman started working at Goldspot, which they describe as an incredibly inclusive queer-owned brewery. Owner Kelissa Hieber found a super trans-inclusive health care plan to cover Laughman\u2019s top surgery.<\/p>\n After waiting 15 years, they got top surgery on October 16. Laughman brewed extra beer to cover the four to six weeks they expected to be out. \u201cBut realistically, the whole plan is for [Hieber] to cover my job,\u201d they said.\u00a0<\/p>\n That level of care is rare in the industry.<\/p>\n \u201cI\u2019ve never worked for an employer who\u2019d say, \u2018Take up to two months and come back when you\u2019re ready,\u2019\u201d says Laughman. \u201cThat\u2019s never been a possibility, which is part of the reason I\u2019ve been so hesitant to pursue [top surgery].\u201d<\/p>\n Laughman says if you need an example of someone doing it right, \u201cGoldspot is it.\u201d<\/p>\n While not every brewery can offer that level of support, Simmons suggests finding creative solutions. \u201cWhat if you take someone out of this really demanding, heavy labor position and put them somewhere else?\u201d she says, recommending a short-term admin role. \u201cGive [them] space and time to come back.\u201d<\/p>\n Alexander feels bittersweet about leaving an industry he loves. But when it comes to top surgery, he says, \u201cI\u2019m pretty stoked!\u201d<\/p>\n Laughman, who has waited over a decade, was very excited to get top surgery. On the day of the surgery, I texted them to check-in. They responded, \u201cSurgery went perfect! And I feel pretty decent still.\u201d<\/p>\n Getting top surgery has been one of the best choices I\u2019ve ever made. It changed my life. I only wish I could have done it sooner.<\/p>\n The beer industry could use its own facelift\u2026or, dare I say, top surgery. Will it hurt at first? Sure. But at the end of the day, \u201cIt\u2019s not only about changing lives,\u201d Simmons says. \u201cIt\u2019s about saving lives. Why not protect your top talent with their top surgery?\u201d<\/p>\nWhy Is Gender-Affirming Care Important?<\/h2>\n
The Challenges of Living as Trans, Non-Binary, or Gender Nonconforming in Beer<\/h2>\n
Taking Time Off, Paying for Surgery, Recovering with Care<\/h2>\n
The Gold(spot) Standard for Gender-Affirming Care<\/h2>\n