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Making the Gendered Face: The Art and Science of Facial Feminization Surgery


Early surgical procedures intended to change a person<&rsquo>s sex focused on the genitals as the site of a body<&rsquo>s maleness or femaleness, and took the reconstruction of these organs as the means by which ,<&ldquo>sex<&ldquo> could be changed. However, in the mid<&ndash>1980s a novel set of techniques was developed in order to change a part of the body that proponents claim plays a more central role in the assessment and attribution of sex in everyday life: the face. Facial Feminization Surgery (FFS)<&mdash>a set of bone and soft tissue surgical procedures intended to feminize the faces of male<&ndash>to<&ndash>female transsexuals<&mdash>is predicated upon the notion that femininity is a measurable quality that can be both reliably assessed and surgically reproduced. Such an assertion begs the questions: What does a woman look like? What forms of knowledge are used to support a claim to know?

This project examines these questions through ethnographic research situated in the offices and operating rooms of prominent American surgeons who perform FFS. I explore the tensions between two different forms of knowledge that surgeons rely on and appeal to in the identification and surgical reproduction of femininity: scientific and aesthetic. The status of <&ldquo>the feminine<&ldquo> at work in Facial Feminization is one that sometimes finds its sense through a link to the biological category of <&ldquo>the female<&ldquo> and other times describes the aesthetic category of <&ldquo>the beautiful.<&ldquo> Though the tension between the female and the beautiful is one that is well worn, it is complicated here by the long<&ndash>contested ethical and medical status of the transsexual body as a site of sex changing interventions. FFS unfolds at the edge of an ongoing history that draws the contested medical and ethical treatment of trans<&ndash> bodies into the rapidly changing field of contemporary trans<&ndash> medicine in the United States. My analysis of FFS, engages with this history and to show how its invocation and articulation in the present gives shape to the ethical and practical dynamics at work in the clinic.

From examinations to final sutures, I show how the distinct histories and epistemologies involved in FFS create new forms of knowledge about the feminine body and, in the process, new ways of conceiving of and living in the transsexual body.

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