MtFtWTF & top surgery

Throwaway cause too many friends follow my main:

Alright so I'm 27. Transfem, I guess, but no particular label seems to fit me anymore, even though I look pretty definitely like a woman. I know testosterone makes me want to die and estrogen lets me avoid osteoporosis so whatever. I'm not stopping HRT. I've been on it for 3.5 years now, excluding two small gaps in insurance. Both gaps were hell, no matter how tapered. Every time T gets above 70 ng/dL I suddenly want to die. Ditto facial hair. Makes that answer easy enough.

But I'm increasingly feeling alienated by my chest? My genetics took over when I started E and I shot up to a C-cup in my first year (wearing a sister size down for lung issue comfort, thus the title pun). For the first 2.5 years I loved my chest. Felt great about it. Wore outfits that complimented it, any time I was with a partner, my shirt was the first article of clothing off.

But I've been, for the last year? Gradually feeling weirder and more alien to it. I've started wearing the binder I got to hide the growth before coming out again. I got a second one, even. Im finding myself feeling exposed in an uncomfortable way when I take my shirt off, and it's stayed on for intimate activities more often than not, especially in the last two months.

I'm wondering about getting a reduction. My legal sex documentation was never changed, so could I get that billed under a gynecomastia coverage? Is gender dysphoria diagnosis flexible enough to encompass a less binary sense of self and cover it? I'm really not even sure where to start here. Before E, I really had never expected to get past maybe a full A-cup chest, and feel like I've gotten more than I bargained for.