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The Face We Put Forward: Experiences and History of Facial Feminization Surgery

Pink background that displays multiple silhouettes of female faces in a range of colors.
Facial feminization surgery allows folks to grow more comfortable with their outward appearance and navigate the world in the way they always hoped to.

Facial feminization surgery has been growing as a gender-affirming procedure and a way to combat gender dysphoria. The demand also sheds some light on the ways we construct gender and sex.

Outward appearances play a big role in our perceptions of gender. Some of us have the privilege to not think too much about it. But for some trans folks, the way that others perceive their gender has implications for their mental and physical health. That leads some to pursue changes like facial feminization surgery — a series of procedures that shape brows, cheeks or chins to appear more feminine — to align internal and external appearance.

Host Anita Rao talks with Emma Ward, a songwriter, producer and community manager, about her experience getting facial feminization surgery. And Eric Plemons, associate professor of anthropology at the University of Arizona, shares the history of the surgery and its significance in shaping how we perceive sex and gender. Plemons is the author of “The Look of a Woman: Facial Feminization Surgery and the Aims of Trans-Medicine.”

Interview Highlights

Ever since I started my transition, I always wanted [facial feminization surgery] … I just wanted to knock out everything so that when I get older, I don’t have to go through the process.
Zuriah Lee

Emma Ward on discussing her desires for her face with her surgeon: 

I think there's been kind of an evolution of how surgeons approach these kinds of procedures to make sure that everybody walks out looking natural. And, you know, they don't look like they were molded in clay or anything. [My surgeon] was very focused on that. I think that was a big part of the reason why I chose to work with him, because he didn't want to do things that would, you know — that maybe I wanted, but wouldn't actually work with my features.

Having the surgery was really important for me to feel better about myself. No matter what your journey, having self confidence will allow you to flourish. I truly feel that in life if something will make you happier then you should go for it.
Capri Celia

Eric Plemons on the demand for facial feminization surgery:

If gender is a social product, it's something that we give to each other through social exchange, then the most meaningful change that a trans woman can make in her body is not in the hidden parts of it, but in the parts that everybody sees. And so I met people, all the way from their early 20s to their late 60s, people who had come to their trans identities late in life, or people who had just finally decided that after many years of waiting to have a procedure done ... [and those] people told me stories of wanting to look in the mirror and see the person that they knew themselves to be looking back at them.

My advice is this: First, take lots of pictures. And secondly, give yourself time. Because you’re going to be swollen like a pufferfish when the surgery is first completed. And your face will change over the coming weeks, months and years. Give yourself time to relax and enjoy the process. Surround yourself with good people. Maybe take a few painkillers. You’ll be fine.
Aluna Vayne

Please note: This episode originally aired November 5, 2021.

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Anita Rao is an award-winning journalist, host, creator, and executive editor of "Embodied," a weekly radio show and podcast about sex, relationships & health.
Kaia Findlay is the lead producer of Embodied, WUNC's weekly podcast and radio show about sex, relationships and health. Kaia first joined the WUNC team in 2020 as a producer for The State of Things.