In a recent Salon article, writer Zach Valenti “manned up” and shared what he describes as his “decade of shame.”

“I was 13 when I discovered my body was different,” he says, although it wasn’t nature that caused this idiosyncrasy.

The majority of people who grow male breasts do so in their teens. Unfortunately for some boys, the drug Risperdal has been associated with male breast growth, leading to a growing number of lawsuits against Johnson & Johnson. It’s already tough enough to be a teenage boy, but add “man boobs” into the puberty mix and it’s difficult to see how anyone can survive the high school years.

“Every finger in the gym pointed to my chest. I looked down at my tender lumps. ‘Titties! He’s got titties!’ the new kid yelled,” reports Valenti in the Salon article.

This was an everyday occurrence for Valenti, who says he did not develop man boobs from Risperdal. Unlike the breast-like lumps that can happen to men with excess weight, the drug can cause gynecomastia which actually causes the breast tissue to enlarge. It won’t go away with weight loss or certain exercises. This male breast growth is identical to female breasts and the only way to change it is with plastic surgery. Considered a cosmetic procedure, it’s costly, risky and painful.

It’s easy to dismiss man boobs, especially in the early stages. A boy won’t wake up and have breasts overnight—it’s a slow transition. However, in the worst of cases, teen boys have reportedly grown up to D-cup breasts even when the rest of their body is slender.

When glandular breast tissue grows and develops, there’s no going back without going under the knife. The New York-Presbyterian hospital estimates that 65 percent of 14-year-old boys have some type of man boobs, but 90 percent of them will regress naturally by the time puberty ends. Unfortunately, that doesn’t seem to be the case with male breasts.

Valenti says he turned to the Internet to find ways get rid of man boobs. Plastic surgery seemed to be the only viable option.

“In my first consultation, my plastic surgeon gave it to me straight: My gynecomastia was never going away on its own.”

Valenti underwent breast reduction surgery in eighth grade, a shame he carried with him for years before telling anyone. According to his Salon article:

“Before leaving for college, my mom asked me if I would speak to another boy from my high school who suffered from gynecomastia and was considering the same operation. I knew the kid, and remembered jokes made in the hallway about his breasts—the curse of being on the swim team. He’d been picked on for years on the premise he was gay. But I wouldn’t do it. That’s how threatened I still felt. I refused to be outed as the guy who once had boobs.”