“I find a lot of patients that contact us don’t really have a hardline ‘I am male,’ ‘I am female’ any more. There is a nice pendulum and spectrum of gender identities that can swing either way…” These are the words of a man who is proud to have performed more female to male (FTM) and female to nonbinary (FTN) top surgeries than any other surgeon in the world. This ‘nice pendulum’ is perfect for top surgeons like Charles Garramone who have been afforded get rich quick schem...