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Published On January 27, 2020

Facial Feminization

Photographer Elle Pérez documents the intimate lives of those in the LGBTQ community.

Facial feminization surgery occurs from the neck up, where strangers most often look for clues to a person's gender. Subtle changes there—removing an Adam’s apple, lowering a hairline, excising tissue from around the eyelids—can profoundly alter how a transgender woman is perceived. Mae, pictured here, had her surgeries three days before this shot was taken. Photographer Elle Pérez documents the intimate lives of those in the LGBTQ community, and this image was shown as part of the 2019 Whitney Biennial in New York City.

While many insurers now cover the costs of some gender confirmation surgery, facial feminization is widely regarded as unnecessary for the treatment of gender dysphoria. Paying for the procedures out of pocket can cost as much as $50,000, and access can be difficult, as nearly half of the states have no physicians specializing in the procedures. Some are advocating—and litigating—for the facial surgeries to become the standard of care, pointing to recent studies that show better mental health outcomes for those who undergo facial feminization.

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