Marisa Kimmel (Part Two): Choosing Yourself, Going Flat, and What We Pass Down

Episode Summary

When Marisa Kimmel chose aesthetic flat closure after learning she carried a BRCA1 mutation, she wasn’t thinking about whether she would still feel like a woman. She was thinking about lowering her risk so she could stay alive for her six-month-old son. The question of femininity came later, handed to her by strangers on social media. Marisa had already done this work once. She was diagnosed with alopecia at nine, and years of trying to hold on to her hair took such a toll on her mental health that she came close to not wanting to be alive. Letting go of her hair taught her that she is a woman because she says she is. Today she feels more feminine and grounded in her womanhood than she ever has, without the two features society treats as proof.

In this second conversation, Sara and Marisa go deeper into what that freedom costs and what it makes possible. Marisa talks about choosing not to delete hostile comments, because people considering the same choices deserve to know that choosing yourself isn’t all good. She describes raising a son who answers questions about his long hair with total certainty, and her plan to let him decide if and when to learn his own genetic risk. She shares the moment her father, also a BRCA carrier, asked her to put a shirt on, and what came out when she asked why: guilt. Sara reflects on the parallel between Marisa’s longing to protect her son and her father’s grief over what he passed down, and on why this podcast exists to complicate the tidy story of risk, surgery, and safety.

We Cover

  • Being diagnosed with a BRCA1 mutation at 26, six months postpartum and still breastfeeding

  • The options Marisa was given, from surveillance to mastectomy with reconstruction to going flat, and why she chose aesthetic flat closure

  • How the idea that going flat would make her less of a woman came from other people, not from her

  • Living with alopecia since age nine, the toll of trying to keep her hair, and how letting go reshaped her identity

  • Hair, breasts, and the cultural markers used to define womanhood

  • Gender, bodily autonomy, and why a body like hers provokes such strong reactions

  • Online harassment, including messages saying she shouldn’t be a mother, and why she doesn’t delete comments

  • Why choosing yourself isn’t all good, and learning not to need anyone else’s approval

  • Breast cancer on her father’s side of the family, often diagnosed in women’s late thirties and forties

  • Watching the women before her make sacrifices, then facing her own choice as a new mother

  • Raising a son who knows he doesn’t owe anyone an explanation, and rehearsing hard conversations with him in the car

  • BRCA in men, and why Marisa will leave the choice about genetic testing to her son

  • Her father’s guilt, his request that she cover her scars, and why his feelings are not hers to carry

  • The parallel between a parent’s longing to protect a child and the grief of having passed something down

  • Choosing to have her tubes removed and have only one child, and why decisions about her body remain hers

  • Complicating the story of hereditary cancer beyond risk, surgery, and “safe forever”


Highlights & takeaways

  • “I’m a woman because I say that I am.” After a lifetime with alopecia and a choice to go flat, Marisa defines her womanhood from the inside out.

  • “I actually didn’t even have that thought in my head once before. It was given to me by other people.” Fears about femininity after mastectomy can be absorbed from others rather than coming from within.

  • “It’s not all good, choosing yourself.” Claiming your body can bring judgment and conflict. Marisa leaves hostile comments up so others can see the full picture before making similar choices.

  • When her father asked her to cover her scars, the reason turned out to be guilt. A parent’s grief about passing down a mutation is real, and it doesn’t have to become the child’s to carry.

  • Sara names a parallel process: Marisa’s longing to protect her son echoes her father’s wish that he could have protected her.

  • “The more that I talk, say the hard things out loud, the softer they feel.” Speaking about what’s hard makes it easier to carry.

Content Note

This episode includes discussion of a BRCA1 diagnosis, prophylactic mastectomy and going flat, hair loss and alopecia, body image and identity, a past period of not wanting to be alive, online harassment including messages encouraging self-harm, breast cancer across generations, parental guilt, removal of the fallopian tubes, and choices about future pregnancy.

Resources Mentioned

Connect

If this conversation spoke to you, follow Walking the Genetic Line, rate and review the show, and share this episode with someone who is weighing their own choices about their body.

Connect with Sara Champie, LCSW at sarachampielcsw.com and on Instagram @SaraChampieLCSW.

Let’s walk this line, together.

Additional support

  • Therapy with Sara Champie, LCSW: Psychotherapy for people navigating hereditary cancer risk, preventive surgery, body and identity changes, and family dynamics. sarachampielcsw.com

  • National Alopecia Areata Foundation: Support, education, and community for people living with alopecia areata. naaf.org

  • 988 Suicide & Crisis Lifeline: If you are having thoughts of not wanting to be alive, call or text 988 in the U.S. for immediate support

Sara Champie

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Rachel Collier: Genetic Counseling Is More Than a Blood Draw, and Testing Is Always a Choice