"Fitness actually allowed me to feel confident in my identity as a trans man," Grayson Vaccariello tells PEOPLE
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Credit: Grayson Vaccariello
NEED TO KNOW
- 21-year-old Grayson Vaccariello tells PEOPLE how his fitness journey and gender-affirming top surgery helped him come to terms with his identity
- “It just felt like me in a way that I have never felt like me before,” he says of seeing his results
- New York City-based plastic surgeon Dr. Keith Blechman says that Vaccariello is a “pillar” in the trans community
Grayson Vaccariello grew up alongside an identical twin sister. They were both tomboys as children, but when his sister eventually grew out of that phase, Vaccariello knew that he was different.
He began experiencing gender dysphoria but didn't yet have the language to name it. When the COVID-19 pandemic hit while Vaccariello was in high school, he finally had the time to reflect on what he had been experiencing for years.
"I was trapped in my bedroom, trapped with my own thoughts, and I was like, 'Okay, this is where I'm going to have to be forced to figure out these feelings,'" Vaccariello, 21, tells PEOPLE.
While he had a supportive family around him, it was still difficult to voice what he had been going through internally.
"I was scared to open up that can of worms, because once you have that awareness, there's no going back," he says. "I was like, 'Okay, well, what if I am trans? I'm too scared to come out. I'm too scared to start asking about testosterone, hormone blockers, all that stuff.' So it was something I waited on."
He first came out as a lesbian to his parents and sister, and all throughout high school identified as non-binary. Switching to they/them pronouns felt like a big step, but it ultimately wasn't enough. Vaccariello then became passionate about fitness, a tool that helped him to come to terms with his identity.
"I was like, 'Okay, I'm probably trans. I'm going to cross that bridge when I get there. There's no rush to it,'" Vaccariello recalls. "But I wasn't fully certain, so I used fitness as a way to build this more 'masculine physique,' build more masculine chest features to see how that would make me feel … that's something that I used to feel confident, and fitness actually allowed me to feel confident in my identity as a trans man."
Eventually, he felt ready to embark on the next step of his transition: top surgery. Vaccariello sought out New York City-based plastic surgeon Dr. Keith Blechman. He had heard of Dr. Blechman through a friend who had also previously gotten top surgery with him. Vaccariello's parents were fully supportive of his decision, and even took care of his friend after his surgery because his own parents were not on board.
Dr. Blechman tells PEOPLE that top surgery falls under the category of gender-affirming chest masculinization. He explains that these kinds of procedures are important because they allow trans people to "separate sexuality from gender."
"They can be related, but they don't have to be," he says. "It's not all about what's happening in the bedroom … that's why not that many people actually do surgery on the genitals. It kind of doesn't really matter. No one's looking in your underwear when you're walking around. But if you're going by the name Ralph and you've got double D breasts, there's only so much you can do."
Vaccariello, he recalls, was "at a point in their journey where surgery is the next logical step for them." After going over his medical history and having him undergo a mental health evaluation, Dr. Blechman decided to move forward with the procedure, which took place on Nov. 12, 2025.
For Vaccariello, the impact of having top surgery was monumental. He recalls the moment he first took his binder off with his girlfriend and mom by his side. "It just felt like me in a way that I have never felt like me before," he says. "That was something I will remember for the rest of my life."
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Through content creation (he boasts 556,000 followers on Instagram) and his LGBTQ+ fitness training business called Masculinity Made, Vaccariello uses his platform to inspire other members of the community to embrace their identity no matter where they are in their journey.
"He is like a pillar," Dr. Blechman says of his patient. "So many people that I take care of, they know who he is. He's a huge influencer in the trans community."
He continues, "Grayson is a very inspiring young person for a number of reasons. But I have found over the years that these people that I do these operations on, I'm inspired in a way because they have such conviction into their sense of self that they're literally willing to amputate body parts. And that's like, 'Wow,' I wish I knew myself that well.'"