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A guide to facial feminisation surgery and why you don’t always need it


TextSophie Wilson

The procedure can be an important part of transitioning for many trans women but when it costs up to £30,000 raising the money often takes years – we explore how you can raise the money and alternatives if you can’t afford it

Facial feminisation surgery (FFS) is a series of procedures that some trans women decide to get to feminise the features on their face. Model and activist Munroe Bergdorf shone a spotlight on FFS in 2018 when she walked at New York Fashion Week just three weeks after getting the surgery. For some trans women, FFS is an important part of easing their gender dysphoria and making them feel safer in public. Though, it’s important to remember that having or not having surgery doesn’t make your gender identity any more or less valid. 

“Facial feminisation surgery can consist of a combination of about 15 separate procedures,” explains Dr Bart Van de Ven, who performs the surgery at 2Pass clinic in Belgium where many trans women go for FFS. “There is no ‘general way’ to approach this surgery,” he continues. “Every patient chooses a specific set of procedures within their facial feminisation surgery, based on the facial features they want to change.”

Consultations, during which the surgeon will look at your face and speak with you about which features you would like to change, can cost between £100 and £500 making even the first step on the way to FFS inaccessible to many. The number of procedures you choose to undergo in one surgery can range from two or three to ten, depending on factors such as preferences and budget.

“During the consultation, I take pictures of the patient,” says Dr Van de Ven. “Based on those pictures, I will make a simulation of the possible result the proposed procedures are likely to have. The patient should take her time before booking and maybe ask friends and relatives for their opinions. My advice is to get as little as needed done, but no less. It’s really important to get your expectations straight before having the surgery, or you may never be happy with the outcome, no matter how beautiful the result.”

FFS can be one of the most expensive parts of transitioning with costs reaching up to £30,000. The amount of time it takes most people to raise the money means that often the surgery cannot be treated with urgency even though it can be lifesaving. London-based artist, musician, and queer icon Xoey 5.0 set up a GoFundMe earlier this year to raise money for her FFS. She received a consultation as a birthday present and set up the GoFund Me once she had a clear idea of the figure she would need to raise. The full quote was £25,000 and Xoey is trying to raise £15,000 through GoFundMe. So far, she has received donations from friends and others in the London queer community, some of whom attend her queer performance art club night WIMP, but she still has a long way to go before reaching her goal.

Her advice for other trans women trying to raise money for their FFS is to start now. “Be entrepreneurial about it. You can be really clever. Use it as an exciting creative stepping stone for you to explore more of yourself and share yourself with others. Put on club nights or put on an exhibition or create a zine,” she explains “There are so many possibilities that can help raise awareness. It’s not all about money. How are you going to raise awareness? Get clever. I don’t think I’ve fully had that moment yet.”

“For some trans women, FFS is an important part of easing their gender dysphoria and making them feel safer in public. Though, it’s important to remember that having or not having surgery doesn’t make your gender identity any more or less valid”

Musician and LGBTQ+ advocate Maria McKee set up See Me Safe FFS Fund in April last year after reading New York-based artist and designer Gogo Graham’s GoFundMe. “You could say Gogo is like our muse,” says McKee. See Me Safe raises funds for trans feminine people saving up for FFS. McKee also promotes GoFundMe pages and helps members of the trans community find places to stay after their surgery. “Cis people are always looking for ways to be allies,” McKee explains. “I wanted to set up a campaign where I can really encourage cis allies to give to help lighten the labour of the trans and gender non-conforming community.”

Another issue that can complicate the path to FFS is a lack of useful, trustworthy information online. While there are certainly many more resources than there were a decade ago, it is necessary to be wary of constructed or hidden reviews. Facebook groups and Reddit are useful for hearing honest personal experiences from women who have had the surgery. You can also reach out to your local community groups and services. London-based queer holistic community centre Elop offers a range of social and emotional support services to LGBTQ+ people and trans activist group Transmissions is somewhere you can go to meet other members of the trans community, ask questions and be heard.

Before model and influencer Jamie Rose Dee had FFS last year, she could not find enough resources online, so she decided to film her surgery journey in an emotional four-part vlog series for YouTube. She hopes that these videos can be used by other trans women in the position she was in. “I wanted to take something that was quite frightening and turn it into something positive that I knew other people could use as a resource,” she explains of why she decided to film the process in such moving, gritty detail.

“Vlogging the whole experience helped distract me during my recovery,” she continues. “I wanted to embrace the recovery period because I knew that I was only going to go through it once. It was like going from a caterpillar to a butterfly. The cocoon phase was something that I was going to try and embrace and cherish.”

Having a large social media following gave Dee the necessary platform to help and inspire other trans women. She has received hundreds of messages from people saying how much her videos have helped them. But having had a significant online following from a young age then coming out as trans comes with its downsides. “There is a big portion of people who feel some kind of ownership of me prior to my transition because they found me attractive as a male,” says Dee. “To them, it felt like they were losing something. It sparked anger out of some people. They were saying ‘But you’re so attractive as a guy. You’re running yourself.’ That’s a very selfish way of looking at it.”

Make-up artist Archie McGoldrick also knows what it’s like to speak about trans issues from a large platform. In 2017, she filmed a video for the BBC about how to feminise your face with make-up that received more than one million views on Facebook. Make-up can be a useful tool for feminising your face without bearing the costs of FFS. It has been invaluable for McGoldrick helping her to ease her dysphoria and ‘pass’ as female in public. However, she notes that “there’s safety in passing but there’s safety in not passing as well. There’s safety in not passing because you’re upfront and you’re not ‘hiding’ anything, so men are not catcalling you. But when you’re passing, men are trying to pursue you or sexually harassing you and when they find out your trans, they attack. It’s very trapping.”

“There’s safety in passing but there’s safety in not passing as well. There’s safety in not passing because you’re upfront and you’re not ‘hiding’ anything, so men are not catcalling you. But when you’re passing, men are trying to pursue you or sexually harassing you and when they find out your trans, they attack. It’s very trapping” – Archie McGoldrick, make-up artist

Whether you decide to save up for FFS or not and whatever stage you are at in your transition, having or not having surgery does not make your gender identity any more or less valid. For many trans women, beauty is tied up with ‘passing’ as female and this is why FFS can be so life-changing. However, the parameters of beauty are expanding as we move towards greater inclusivity. There are more trans models on runways and in magazines than ever before but to be truly inclusive we need trans and gender non-conforming representation even when it’s not palatable to a mainstream heterosexual audience. 

As McGoldrick concludes, “Beauty needs to be more diverse because right now it pigeonholes us into ideas that are very gendered and heteronormative. I still compare myself to cis girls with lower hairlines who look like they’ve had FFS but that’s just how they naturally are. But beauty is not about comparing yourself to others. Sometimes I feel most beautiful when I’m by myself and not even thinking about gender. When I bypass gender and just see myself and the beauty of me as a human being.”

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