Facial Feminisation is one of the most sought-after procedures by those who, assigned male at birth (AMAB), wish to soften specific facial features to best align with the stereotypically female facial characteristics of an assigned-female-at-birth (AFAB) individual. Nonetheless, especially by today’s standards, deciding what looks more feminine and masculine has become less of clearcut matter and more of a subjective conversation. While cis-gender women are starting to distance themselves more and more from societal pressure and embrace their features – whether they be stereotypically considered masculine or not -, consequently, transgender and non-binary people feel they no longer need to fit any boxes and that altering aspects of the body and face is more related to how they feel about themselves, rather than what label or gender society attributes their appearance to.

Acknowledging the reasons behind deciding to undergo facial feminisation surgery is key to understanding how procedures such as feminising rhinoplasty, tracheal shave, and jaw and chin contouring – to name a few – don’t really associate with what we normally describe as “cosmetic procedure”, not in their natures or in how these procedures are performed on trans and non-binary patients, but rather in their motives and goals. In “Position Statement on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage in the USA1”, FFS is described as medically essential to the well-being of transgender individuals. The document states “these surgical interventions are often of greater practical significance in the patient’s daily life than reconstruction of the genitals.” This statement alone is sufficient to demonstrate how effective FFS can be in ameliorating a trans or non-binary person’s daily life by shortening the distance between one’s felt gender and the personal idea of what “feminine” means.

Facial Feminisation, therefore, shouldn’t be something that every trans woman needs to consider and, on the same premises, FFS probably is not a necessity for everyone, as it shouldn’t be based on how much of a woman people perceive us as, nor how more feminine we would look in the eyes of a society which is anxiously chasing after what’s “normal”. Our decision to alter aspects of our face should solely be based on our opinion of ourselves, and how much we think a procedure can alleviate the sense of dysphoria we feel. Without a doubt, it would be hypocritical to deny that striving for a more cisgender-looking aspect is often, in reality, a consequence of transphobia and ostracisation and an important need from trans people to feel safer in their daily life. If you are considering Facial Feminisation Surgery, my advice would be to think carefully about the reasons that led you to that decision. It’s important for anyone contemplating having surgery to recognise that the ultimate goal of FFS is exclusively to feel more welcome in our own world which is ruled by laws that only we dictate.

  1. WPATH (2016) Position Statement on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage in the USA. Retrieved from: http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1352&pk_association_webpage=3947