Am I experiencing gender identity issues at 22?

FMGA surgery DOES NOT allow for biological pregnancy.. 

It is usually not recommended to get top surgery at 13. One should atleast be 18 years of age to get top surgery. 

Men who are transgenders assigned female at birth still possess uterus, and consequently continue to menstruate as normal. Hormone therapy commonly used in the gender transition brings about a significant decrease or cessation of menstrual bleeding. In order to get personalized advice regarding the management of menstrual health for those going through gender transition, a specialist in transgender medicine or endocrinology needs to be consulted.

Starting the Opill birth control for breast enlargement can be risky. Use of birth control pills for a long time can cause problems such as high chances of blood clots, weight change, and emotional state. The hormone progestin in the pill can affect my levels of hormones. There are also claims that birth control pills made of progestin can affect the production of hormones. Consult your healthcare provider to make a safe decision and avoid risking negative consequences. 

If you don't take testosterone or undergo top surgery, you can still build your pecs by lifting weights. Pecs, short for pectoral muscles, can grow with exercises like chest presses and push-ups, which target these muscles. Pace yourself, use the correct form, and be consistent with your workouts. Your pecs can still develop even without testosterone.

Usually, top surgery is suggested when you are 18 or above the age of 18. But you can get top surgery at 16 if you have your parents approval and after consulting with a qualified doctor. 

Before undergoing mtf or ftm, the doctor may suggest doing some tests. 

Tests for mtf

• Hormone level testing
• Pelvic exam
• Breast exam
• Prostate cancer screening

Tests for ftm

• Hormone level testing
• Pelvic exam
• Breast exam
• Cervical cancer screening

Other than the tests, the healthcare provider may give certain instructions. For example, if you are planning for a hormone therapy, you may be given instructions on how to take the hormone medications and how to monitor for potential side effects etc. And in case of a surgery also, you may be given certain instructions on the diet you need to follow, and which medications you should take or not take, etc.  

It is important to work closely with your healthcare provider and follow all the guidelines and instructions given by him to have a smooth transition journey. 

It seems like you may be going through some changes about turning into the opposite sex. Understand that these changes are complicated and might need some medical interventions. You might require different amounts of hormones to help you through the process. Talk about what is bothering you and your symptoms with a doctor who can help you figure out the best way forward.