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I put this in s/funny because I bet most people think its a meme. It's real. He even talks about feeling effeminate so he worked out all the time to kill his depression and used high protein diets and developed a "large thirst" because of his "big lust". I think that is metaphorically pretty self explanatory to why he only got the tits and the plastic surgery.

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Does he mention plastic surgery

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No, but emphasizes how he became Michelle with some strange anecdotes and "daydreams" from what I skimmed through.

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Wow xD