"The Sciences of Facial Feminization Surgery"

Facial Feminization Surgery (FFS) is a set of bone and soft tissue reconstructive surgical procedures aimed at feminizing the faces of male-to-female transwomen. FFS is constituted by a tension in which “feminization”—and notions of “the feminine” that animate it—sometimes refers to the aesthetic category of the beautiful, and other times to the bioscientific category of the female. The surgeon who developed FFS in the 1980s and remains its leading practitioner worldwide, relies upon the ideal of a scientifically derived female form to communicate to transwomen patients what FFS can do for them: If it is the case that males and females look different in measureable and reproducible ways, then changing facial sex is not only possible, it is virtually guaranteed—by the right surgeon, that is. In this paper I examine the origin of FFS from the initial patient request that prompted its development, through the research process that ultimately produced the female face that FFS aims to create. I examine how the three forms of knowledge used to develop these surgical procedures—(1) anthropological methods for sexing human remains, (2) measurements derived from a series of dental and orthodontic cephalograms, and (3) a dental school’s dry skull collection—were marshaled to naturalize and stabilize a distinctly female face from the wide variety of human craniofacial forms. It is this face that animates surgeons’ work and patients’ desires.