FFS Overview

It’s the first thing you look at when you meet someone. A person’s face provides cues about seemingly every aspect of their identity–what they are thinking, how they are feeling, their race, age…their gender and more.

Facial Feminization Surgery (FFS) is a medical procedure that transgender women undergo to alter their facial structure to appear more feminine. The surgeon contours the bones of the jaw, brow and forehead and also performs a rhinoplasty (nose job) and Chondrolaryngoplasty (tracheal shave–to remove the Adam’s Apple).


Trans peoples’ opinions of FFS and medical interventions in general vary. There are many people who do not to go through FFS for financial reasons or personal objections to the notion of “passing.”

Passing is a concept that cuts across identities but is particularly important in the trans community. If you are trans, to “pass” means you are undetected as transgender in society because people cannot detect your birth sex. Passing usually feels like social acceptance. It alleviates the discomfort of being outed by someone’s gawking across the subway. It lends a sense of privacy. It a lot of cases, it is more comfortable.

Some trans people want to pass and would rather live their lives in their authentic gender without anyone knowing their trans status.

Other trans people see passing as harmful to the trans community because it decreases trans visibility in the part of the community that tends to have the most social capital while leaving the disenfranchised members of the trans community without protection or support.

Considering Beauty Standards and Privilege 

FFS can be seen as very privileged and informed by gender norms that trans people would otherwise reject.

FFS ranges in price and can cost tens of thousands of dollars depending on your surgeon and the number of procedures you have done. That puts a hefty price tag on passing. A person needs to be able to raise the money, have excellent health insurance, take out loans or be independently wealthy to afford the procedures.

FFS can also reinforce gender and beauty norms that are negative to women and general, let alone trans women. The procedure puts a premium on petite upturned noses, slight brows and small foreheads–features that aren’t necessarily specific to the female form, though they are features that are specific to a Caucasian/European facial profile.

I’m Doing It!

I’ve known I’ve wanted to have FFS before I even knew what it was. Some of my friends and family ask me if I am nervous to look in the mirror and not see myself in the reflection. The truth is, I haven’t seen myself in my reflection for decades since puberty.

I want to pass but I don’t want to deny my trans identity. It’s not just that I want other people to see me a certain way–though I do. I want to see myself and recognize the person in the mirror. Every time I look at myself, the masculine features in  my face are screaming at the top of their lungs. It will be a huge relief to look at my own face and see the woman I’ve always been.

My FFS consultation is scheduled for May 1 with Dr. Jeffrey Spiegel, which I will post about! My goal is to schedule my surgery for August. Everything is covered by my incredible insurance through Harvard Pilgrim Healthcare.

The Take Away

Do what makes you feel good about yourself but do it for you and not because you feel pressured to look a certain way. You don’t have to do FFS to be trans. Heck, you don’t have to take hormones to be trans.

Every step in the transition is completely up to your comfort and hopes for your life.


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