Emily Hopper, 32, is a breast cancer advocate, artist, and mother. In 2017, Hopper was diagnosed with breast cancer. Shortly thereafter she underwent chemotherapy, a double mastectomy without reconstruction, and radiation. In 2018 she started EMPOWERHAUS, an online business to embolden and inspire breast cancer patients. She is still in active treatment.
Catherine Guthrie, 47, is a women’s health journalist who went flat in 2009 after being diagnosed with breast cancer at age 38. Guthrie’s queer, feminist cancer memoir, FLAT: Reclaiming My Body from Breast Cancer, is forthcoming in September from Skyhorse Publishing. She is currently in remission.
The phrase “going flat” has been adopted by folks who’ve chosen not to reconstruct after losing either one or both breasts to cancer. Although choosing not to reconstruct after breast cancer isn’t new—experts estimate that half of all women who lose one breast to cancer stay flat and the number of double-mastectomy patients who go flat is 25 percent—what is new is a burgeoning trend of survivors embracing (dare we say flaunting) their flatness.
Up until recently, most breast cancer patients who’d gone flat hid behind prosthesis. For sure, many still do. But in much the same way that LGBTQIA folks are increasingly living out loud, breast cancer patients who’ve gone flat are starting to come out of the closet in a big way. Women who’ve chosen to go flat have appeared in traditional media, including The New York Times, The Chicago Tribune, and the CBS Sunday Morning Show, as well as pop culture venues, such as the Amazon show "Transparent" featuring a flat Anjelica Huston and an HBO special with flat comedian Tig Notaro, who did part of her set topless. Recently, Catherine Guthrie talked with Emily Hopper about the motivations and consequences of going flat.
Catherine: So, what motivated you to go flat?
Emily: It was your article! [in the October 2017 issue of O, The Oprah Magazine, “Why More Breast Cancer Survivors Are Going Flat.”] To see the photograph of Beth Fairchild was so empowering. [The magazine illustrated the article with a photo of Beth, a flat tattoo artist and stage 4 cancer patient.] She looked like me in that she was tattooed and bold as fuck. And even though she had no breasts she was still so beautiful! That was the first time I’d ever seen anyone like that.
The size of my tumor meant I had to do chemotherapy before surgery, so that gave me plenty of time to weigh my options. In your article you mentioned a Facebook group called ‘Flat & Fabulous’ so I joined. I also became a member of a Facebook group for breast cancer patients going through breast reconstruction. In the Facebook groups, I saw some women had great-looking reconstruction, but I also saw a lot of things that terrified me. Women posted stories about horrible complications and loss of sensation. I didn’t want to lose sensation in my chest, and I wanted to do whatever got me back to playing with my daughter, Mia, the fastest.
Catherine: You’ve been in a relationship for 12 years, married for three. Clearly, you are the boss of your body, but did you include your husband in your decision-making process?
Emily: Yes, we sat down and looked at photos together. We looked at pictures of women with reconstructed breasts as well as photos of people who’d chosen to go flat. The photos of the reconstructed breasts didn’t resonate with me. We talked about it, and I told him that I couldn’t imagine not being able to feel him touching me. I worried the loss of sensation would leave me feeling disconnected from both him and my body. Ultimately, he was supportive of me going flat.
Catherine: Because I’m in a queer relationship, my partner and I had already moved beyond preconceived notions of what women “are supposed to bring” to the bedroom. How was it for you being married to a man?
Emily: Honestly, his support surprised me at first. Our culture puts so much emphasis on how much men are supposed to love women’s breasts, I worried he might not be sexually fulfilled. But he’d seen me go through hell, and he just wanted me to feel better. In the year since I’ve gone flat I have had moments when I worried maybe he needed breasts in his life. But he says he doesn’t miss my breasts nearly as much as he thought he would. And because my chest has full sensation it still feels very intimate when he touches me. I’m more confident in my body and in myself, so that helps in the intimacy department too.
Catherine: My favorite thing about being flat is a sense of ease in my body. I was able to fully restore my strength and range-of-motion after surgery and both of those things are super important to me. What has been the best part for you?
Emily: It’s hard to put in words, but I’d say it feels free. Women’s breasts are so highly sexualized in our culture. Not having breasts gives me a sense of freedom I never knew I wanted. In some ways it feels like a new level of womanhood. I’ve grown into this person who isn’t defined by her breasts and that is really powerful. Then there are the practical things like I healed from my surgery quickly and was able to get back to living my life. And the little things, like I’ve got no more breast sweat and I no longer have to worry about whether or not they are hanging out of my shirt! (Laughs.) Plus, I can go from a hot summer day into an air-conditioned store and my nipples aren’t don’t show!
Catherine: I think a lot of readers will be surprised to hear you describe going flat as reaching a “new level of womanhood.” Could you say more about that?
Emily: Sure. I’ve always been very shy. I was bullied in school because I didn’t fit in. I never loved my body. After my double mastectomy, I was prepared to feel devastated because doctors had told me my self-esteem would suffer if I went flat. But the first time I saw my flat chest in the mirror I wasn’t upset at all. I felt proud. It was the most empowering thing that ever happened to me. I had no idea I’d still be beautiful even without breasts. For the first few seconds, I didn’t even notice my breasts were gone. That was powerful. It was as if I was seeing the real me for the first time. Because of that sense of coming into my personal power and beauty, I feel like more of a woman than I did before.
Catherine: I’ve been flat for nearly 10 years now, and I’m surprised at how few people really seem to notice. What has surprised you the most about living flat?
Emily: I totally agree! A lot of people who go flat are worried that everyone will notice but they rarely do. With my newfound confidence and body love, I wouldn’t care if they did notice. I’m proud of what I’ve overcome and my chest shows it.
Catherine: I don’t want to make it sound like going flat is a walk in the park. For starters, we both had breast cancer in our 30s, which is traumatic. And, I don’t know about you, but I miss my breasts every day. What’s been the hardest part for you about going flat?
Emily: I definitely have days when I miss my breasts, but, ultimately, I’m not sad that I’m flat, I’m angry that cancer took my breasts. I’m also mad that cancer stole a year of my life with my daughter. Mia was 14 months old when I was diagnosed and treatment meant I missed a chunk of her life. That’s hard to reconcile. I’m never going to get that time back. But, at the same time, she kept me going. She still keeps me going. She is my silver lining.
Catherine: What do you think is the biggest misconception about “going flat?”
Emily: First, people think a woman has to have breasts to be beautiful, which is definitely not the case. We are not defined by our breasts. Second, that she’s going to regret her decision to go flat. People need to give women more credit. We are strong. We know we want. Don’t second-guess us. I am much more confident now that I am flat. I know who I am and what I want in life.
Catherine: When I first went flat I struggled to find clothes. Everything I wanted to wear seemed to be built for breasts. How did you handle the clothing transition?
Emily: I went through every piece in my closet and found that most of my clothes actually fit me better than they did before. I also went to the local thrift shop and pulled every top and dress that remotely interested me. I’m talking about more than 100 pieces. Then I spent an hour trying them all on. I walked out of that store with a sense of what looked good on my new body as well as a handful of new pieces, including styles I could never have pulled off with breasts. That made me feel sexy! I’ve had a lot of fun dressing my new chest. My favorite things are dresses and tunics. I especially love dresses that are tight on top, which shows off my flat chest, and loose on the bottom, which gives my curvy hips lots of room.
Catherine: We were both quick to speak out about our experiences. I started a blog and wrote a memoir titled, FLAT. You photographed your process from day one and now you’re advocating through your EMPOWERHAUS brand. What prompted you to be so out and proud about going flat?
Emily: I’ve been blogging through Instagram for years (@Mrsemilyhopper) because I love telling stories through pictures. I was young, I was misdiagnosed, and I knew that one in eight women get breast cancer, so those three things compelled me to share my story. I feel strongly about advocating around going flat because that option wasn’t presented to me. If anything, doctors discouraged me from going flat by telling me how much I’d regret the decision. But going flat was the best choice for me and it probably is for lots of women.
Catherine: I don’t have kids, but breast cancer patients have told me they chose to reconstruct for their children, especially their daughters. They didn’t want their kids to be reminded of cancer or even worry about getting it themselves. When she’s older, what do you plan to tell Mia about your decision?
Emily: Parenting is so personal, so I understand where those parents are coming from but I’m going to tell Mia the truth. I’ll tell her that my breasts were making me sick, and I did what I had to do to live my best life. I don’t want to scare her, but it’s important for me to be honest with her, especially because we do have a family history. I do worry sometimes that she’ll be impacted by having seen me go through cancer. But, ultimately, I hope that she’ll be a stronger person for having seen me speak my mind and live my truth.