This paper explores existing feminist body positive frameworks and queer theories of embodiment while asking troubling questions about bodies between and outside of binary, cisgender frameworks. We consider how feminist psychotherapy offers some possibilities and occludes others when applied to the desire to redistribute or shrink chest tissue. Using psychoanalytic theory, we aim to uplift alternative (and, at times, uncomfortable) clinical considerations to better understand the relationship between our patients and their bodies. To guide feminist therapists, we propose a framework of mourning and materialization. Specifically, we suggest that therapists practice reflexivity and collaborate with their patients to determine what aspects of the ideal body to mourn and what aspects can be materialized through surgery or other forms of bodily change.