A voluntary double mastectomy is undoubtedly one of the most drastic transformations anyone could make to their body. That someone could be so dissatisfied with what they see in the mirror that they turn to the surgeon’s knife is a difficult concept for most cis folk to comprehend.

Yet Sarah Keyworth treats this hot-button subject with the lightest of touches. The comedian casually comes out as non-binary and just as effortlessly dodges dwelling too much on what led to this significant decision. Just know it has made them much happier in their own skin and that, despite what wider anger ranges about anything concerning gender or even pronouns, Keys’ decision was warmly accepted by those closest to them.

Avoiding the soul-searching ensures My Eyes Are Up Here is a show beaming with positivity for Keyworth’s gender journey, empowering for those on a similar path and heartwarming for everyone else. 

The show rests on the comic’s relationship with their mother, from surly, disorganised teenager to a 30-year-old acknowledging they were raised with love and semi-reluctantly accepting that some of those parental diktats might actually have been sensible. That’s tied with the realisation that Mum might have had a more lively and interesting life than the stand-up ever credited.

It’s that relationship that forms the heart of this show before the more obvious dramatic pivot regarding the top surgery. It takes several minutes for Keyworth to even mention that point, and even after they do, they park the notion for a while, as if to let the audience process the news before returning to it in a little more depth.

Along the way, we get more straightforward jokes about a lesbian foursome or an amusingly vivid anecdote about the poor male lap dancer dispatched to perform to Keys and the rest of a non-binary hen/stag party (a ‘them do’ is apparently the term) in a grim caravan park. 

By their own description, Keyworth is an ‘emotionally unstable non-binary person’ thanks to their ADHD – though the ‘H’ is notably absent. Keyworth is nothing if not laid-back in their delivery of comedy, which is defined by charming, mild self-deprecation and the occasional delightful one-liner.

In their quest for inclusivity, Keyworth even tries to celebrate straight men – a demographic that’s usually comedy’s whipping boy, and not without just cause – all the in the spirit of drawing focus the best in humanity, not the worst. Even if bigotry is in right now… it certainly drives that precious, monetisable, social media traffic the comic’s way.

Given how keenly relevant Keyworth’s story is, it often feels like there’s more to be mined in their story of gender dysphoria – ‘not a mental illness… any more’, as the therapists constantly mention. In one telling line, for instance, the comic says they *think* they are non-binary… but they took a pretty bold move if this was just a hunch. 

And late in the show it’s revealed that there’s a specific reason why the comic’s mum might have been against the top surgery, though it’s to her credit she didn’t let that stop her child doing what might make them happy. 

While exploring these avenues would provide depth, it would come at the expense of the remarkably light touch Keyworth brings to their story. Sometimes it seems a bit too frivolous – a running gag about the comic morphing into their brother feels contrived, for example – but generally these experiences benefit from being told in such an endearing, human way far from the toxicity of social and old-school media. The result is a touching and affirming hour.

• Sarah Keyworth: My Eyes Are Up Here is at the Soho Theatre, London, until Saturday. It then plays the Edinburgh Fringe in August and tours in the autumn. Sarah ​Keyworth tour dates