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Advanced Rhinoplasty
Published in Suleyman Tas, Rhinoplasty in Practice, 2022
Adam’s apple: Men have a larynx bump called the Adam’s apple while women do not. Rhinoplasty is also a part of sex reassignment surgery, so understanding the gender differences in noses is essential. A cosmetic procedure known as facial feminization surgery aims to form more feminine features on men, so the previously mentioned differences are eliminated. During this procedure, to cover the supraorbital ridge in male patients, either fat can be injected in the concave area or the forehead can be totally exposed through a bi-coronal incision in a more aggressive surgery where the ridge is either rasped or remodeled with osteotomies. The lips, jaw, and face gain more oval lines through the fat injections. Then, the Adam’s apple is incised, and surgery is performed on the vocal cords. Surgeons need to be quite careful in nasal operations for male patients; otherwise, the surgery can transform these secondary sex characteristics in their patients.
Transgender and Gender Diverse Care
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Transfeminine procedures includeBreast augmentation (“top surgery”)Facial feminization surgeryThyroid chondroplasty
Trans Care Within and Against the Medical-Industrial Complex
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
Each day, my social media feed is populated with crowdfunding requests for surgery. Often, it’s for facial feminization surgery, which is nearly unilaterally denied coverage. Other times, it’s a request for top surgery, from uninsured and underinsured trans masc folks.
Facial Feminization Surgery: The Ethics of Gatekeeping in Transgender Health
Published in The American Journal of Bioethics, 2018
Facial feminization surgery refers to a set of surgical procedures that alter the characteristic male facial features to provide a more feminine appearance. FFS procedures include common facial plastic procedures like brow lift, rhinoplasty, cheek implantation, and lip augmentation, as well as more specific ones intended to modify bone structure like scalp advancement, frontal cranioplasty, and reduction mandibuloplasty (Ousterhout 2015). In most cases, the desired degree of feminization is impossible to achieve through soft tissue procedures alone, since bone structure provides the architecture of facial sex differences. In this regard FFS is different from cosmetic surgery (Altman 2012). The objective of FFS is to decrease gender dysphoria by aligning the facial features of gender with the inward identification of gender. Male-to-female (MtF) transgender persons have greater difficulty changing their outward appearance compared to FtM transgender persons (van de Grift et al. 2016). Facial features, such as jawline or facial hair growth, are difficult to modify and they are often the main area of concern for MtF patients. It is essential for these patients that their facial features be adjusted in such a way that the face will be recognized as belonging to the female gender.
A Queer, Feminist Bioethics Critique of Facial Feminization Surgery
Published in The American Journal of Bioethics, 2018
Dubov and Fraenkel embrace the current “scientific community’s understanding of gender identity” (Dubov and Fraenkel 2018, XX). In contrast, Queer, Feminist bioethics questions the basis for the scientific community as an authority, since women, feminists, people of color, and queers—the very individuals who have the most invested in their medical lives—are often excluded from these guilds. Even when they hold token positions, they are likely to maintain the status quo by mimicking conventional dogma rather than advancing liberatory concepts. Dissenters are intentionally barred from these power structures and rejected for their upsetting ideology. Oppressive stakeholders in the scientific community include profit-driven pharmaceutical and medical companies, heterosexuals, cisgender men, and representatives of various non-Queer, anti-Feminist commitments. These individuals are not inherently unethical; indeed, that would be essentialism. But, rather, they must be viewed with a hermeneutics of suspicion. The mantra “nothing about us without us” should be heeded when making medical decisions, policies, and treatments for LGBT (lesbian, gay, bisexual, transgender) people and cisgender, heterosexual women. This commentary analyzes the concept of facial feminization surgery (FFS), as a social response to gender ambiguity, through a critical Queer, Feminist epistemology.
Faces Matter
Published in The American Journal of Bioethics, 2018
Zil Goldstein, Jess Ting, Rosamond Rhodes
Because the face is visible to the outside world, while the genitals are concealed by clothing most of the time, the impact of facial feminization surgery is often far more important and a greater benefit than genital surgery for transgender patients. The changes that come with facial feminization procedures will affect the way someone is seen in the world on a day-to-day basis. Being seen as a woman is important for transgender women, not just because it reduces the distress caused by constantly being seen as a man, but because it can save a transgender woman’s life. Transgender women who are betrayed by their features, a prominent Adam’s apple, for example, are commonly assaulted, and sometimes murdered because they are transgender. Nevertheless, access to the facial reconstruction surgery that is needed to produce feminine facial features is typically limited to patients who have the means to pay out-of-pocket, and the costs can run into many tens of thousands of dollars. Patients who lack the means to pay for these expensive procedures are left to endure repeated assaults and threats of violence from people who are offended by the incongruity of their dress and their facial appearance. Patients at the Center for Transgender Medicine and Surgery at Mount Sinai have repeatedly told our staff about the way they not only are treated differently, but are safer and harassed less frequently after their facial feminization procedures.