Facial feminization surgery

Approximately 1.4 million people in the U.S. identify as transgender or gender diverse. One of the biggest challenges to transgender individuals is acceptance in society. Facial feminization surgery (FFS) is a gender-affirming procedure that not only helps trans women become their authentic selves, it saves lives. 

The goal of FFS – which employs multiple facial procedures of the brow, nose and chin – is to ease the transwoman’s psychosocial burden. It has been associated with improved mental health and quality of life.

James Bradley, MD, vice chair of plastic surgery at Northwell Health, and his colleagues were the first to show that virtual treatment planning before FFS provides superior results in terms of accuracy, safety and efficiency. They were the first to confirm that both facial recognition software, which uses artificial intelligence, and people correctly classify transwomen as “women” 98 percent of the time after surgery. 

Joining Dr. Bradley on the podcast are Northwell physician assistant Sabrina Sam and FFS patient Rubi, who underwent the procedure in 2020 amid the COVID-19 pandemic. She shares her story and why she says FFS saves lives.

 

The problem

Despite hormonal therapy, voice training, make-up and hair, transwomen are at risk for mis-gendering. Even with the growing number of non-discriminatory protections for this population, many continue to face bias in employment, healthcare and housing. This, along with the effects of gender dysphoria, can lead to high rates of depression, anxiety, self-harm and suicide.

 

Artificial intelligence and virtual planning

Building on the surgical techniques originally developed in the 1980s, Dr. Bradley has made the various operations involved in FFS safer and more efficient through years of research. His first study focused on improving the safety, accuracy and efficiency of FFS through the use of virtual surgical planning, which entails developing computer models and physical prototypes before the surgery to use as aids during the procedure. 

Two more studies examined whether facial recognition software and people could differentiate between cis- and trans-women after successful FFS based on images of faces. These were the first studies ever to evaluate the impact of FFS on how transwomen are gender-typed by both artificial and human intelligence.

Hear from more transgender women about FFS. 

Watch episodes of 20-Minute Health Talk on YouTube.