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My Facial Feminisation Surgery

Smoakie Bulle Just after midnight on New Year’s Eve 2000, six months or so ago, my friends and myself were invited into a house across the road from where I live to join a party. It was one of those only- on-New-Year’s-Eve-with-a-skinful-occasions, and when I went in I was treated as the bloke across the road in a frock. It was he and him without cease – they just saw me as male, unbelievably, and I began this year deep in yet more of those unending tears back at my flat. Will this never end, I said, is there no way out of this? After all I have done, after living well as a woman for all this time, rarely read, or so I thought, after Sex Reassignment Surgery, after thousands of little white oestrogen pills, with a skin like a baby, a girl at last and happy and well in my world? After all I’ve been through, and it means nothing?

Right, I said to my partner, gritting my teeth yet again, this is it. I’ve had enough, I won’t live with this. I’m going to have my face fixed this year no matter what. You see, I knew what it was these people were seeing, what it was in me that made them see the old maleness; it was in the structures of the bones of my face, and this is what I decided had to be changed. In for a penny, in for a pound, that’s my way. I forgot how to spell kompromize a long time ago. Why stop before the end? Why not the best?

I stumbled on the Anne Lawrence website ( years ago, and with its links it has led me through many a maze, and it was here that I learned of Facial Feminization Surgery (FFS). Go and look for yourself, and what you will find is a revelation. Once you see it, it’s obvious, and male and female faces are never the same again. It all comes down to hormones again, that demon testosterone and the ravages it had on our bodies and minds.

In late adolescence, boys turn into young men. I’ve watched this happen to my son, who is now eighteen. The bones change, and what makes a man a man, and brings a woman like myself a life behind a mask, is the creation of, from the top down;

The brow ridge, and brow bossing. For me, the most significant of all. Like many results of the work of testosterone, my browridge formed almost a hood over my eyes. The line of the forehead in profile came down, then out just before the eyes, then right in. Oestrogen does not make this happen, and the brow in natal women remains the same as in children, where the line of the forehead comes straight down, leaving the eyes more open and unhooded. As we first look at the eyes when we meet someone, this subconscious marker of gender is highly significant.

The nose in the natal female is often smaller, narrower, less significant; the testosterone nose wider, more powerful a presence.

The prominence of the chin and the line of the jaw. This is more well-known. The female chin comes more to a point, it is rounded and is slighter in profile; it doesn’t stick out so much. The testosterone jaw is often wider, coming to strong angled points below the ears.

Of course, faces come in billions of forms, none of them the same, and masculinity and femininity shows in other ways on the face, but the main markers of maleness and femaleness are consistent. Freud said that the first point of recognition when we meet a person is that of gender; is this a male or a female? The rest of identity follows, is built on this. The subconscious indicators of gender come in the form of dress and body language, ways of moving, ways of dressing, the skin, the voice, the way we speak, the way the person feels to us; on and on. Many of these we can work at and change, but the bone structures of the face, the frame upon which the skin hangs, can only be changed by surgery, and this is what we look at first, this is what sets the tone for all that folows.

If you look on the Net, you will mostly see the work of Dr Ousterhout in San Francisco. The results of this surgery can be astonishing; craggy male faces turned into attractive women’s. For some, a life which would be unbearable becomes a joy.

No wonder so many transsexual women don’t mind what Dr Ousterhout charges; anything to get me out of this! When I contacted some of the women who had put their results up on the Internet, I was told of Ousterhout’s costs, and my heart sank. Around $28,000. Plus two trips to San Franscisco. It comes to around £20,000. A great surgeon, no doubt, but way too expensive for me.

So I looked for alternatives. This was not so easy. What I was looking for specifically was a cranio-maxillary-aesthetic surgeon with experience of transforming the transsexual face at a good price. I needed a surgeon who works with the bone structures of the face, with empathy and understanding of who and what I am, and these guys hardly come on every street corner.

Still, with determination I found one, not advertised at all, tucked off in a corner of Belgium. Dear Dr Noorman van der Dussen. I went to see him in February, loved him, and had extensive facial surgery at the Eeufeestkliniek in Antwerp on April 18th. Not bad, eh? Less than four months from New Year’s Eve and it was all done.

I had my brow ridge removed; Dr Noorman van der Dussen (all of this is his surname, let’s call him Dr NvvD) told me afterwards that he had removed about 1 centimetre of bone from over my eyes. A centimetre! Usually these things are done in millimetres. I had a lot to lose.

My nose, which was always slender, had its upturned, ski-jump end removed. My upper lip was enhanced. My chin was narrowed, taken back, the angle changed, and the jaw line altered to fit. Seven hours on the operating table; not a small thing to do.

I left the clinic the day after surgery and went to a hotel, amazingly, but it was fine. As Dr NvvD said, all you need is comfort to recover, better and cheaper in a hotel. I had two days of great discomfort, but almost no pain at all, thank God. How lovely I looked; bandages over the scalp, right round the jaw, my nose in a plastic cover taped to my face, one eye closed completely and the colour of a red fruit, the other open a crack, gorgeous colours everywhere, looking like a creature from a strange part of the universe in Star Wars.

But recovery was swift. Five days after surgery I was out in the Belgian countryside with the friend who came with me – bless you Jane, where would I be without you? – and a new transsexual friend I made in the hotel, enjoying pancakes and coffee. Avoid the tea; this is not England. I had on so much covering make-up I could hardly lift my head, and there was swelling in plenty which made me look a little odd, but I made it.

Then I was back home less than a week after surgery, feeling tired and full of anaesthetic, but not too bad. No signs of surgery at all. Incisions were made behind the hairline for the forehead, inside the mouth for the chin and jaw. It was like a miracle had happened.

It took a few weeks for the whole thing to settle in properly, but it did, and now I am fine. But the test of the pudding is in the eating, and the test of FFS is not only in the looking, but in how I feel, the most important thing of all. And what I have to tell you is that I am very happy. It’s made all the difference in the world. When my friends look at me, they still see Persia. It’s not as if I have another face; what’s happened is that my own face has been softened and opened. It has been feminized. The work is subtle and very well done, integral, looking so natural that many people have no idea anything has been done at all. You are looking well, Persia, they say, not knowing what they are seeing.

The greatest effect can be seen in profile. All the prominent angles of my face have been removed. The overhanging brow, the ski-jump nose, the angular chin, all replaced with softness. I love it. I now have none of the indicators of the male on my face. I have always felt that the transsexual transition was, for me, a restoration of my own true being, and now I have even restored my own face. It is no longer the face of a brother I never had.

And I feel completely relaxed now. I am seen as a woman now, almost completely, except for on one of those bad days when nothing goes well. I am what I am, a transsexual woman, and there will always be someone somewhere who knows. But so little, so rarely that I no longer care.

The feelings of this cannot be expressed better than in the words of anon (name witheld by request), who underwent FFS at the hands of Dr. DouglasOusterhout in San Francisco, but the same is true of Dr Noorman van der Dussen, and anon expresses my own feelings with a beauty I cannot hope to match.

” When I went out before my surgery, no amount of radiated joy and peace would have kept me from being perceived oddly by some. I’m not talking about passing here, I’m talking about how, as a human being, people saw me. I want people to see *me* clearly, not through the filter of doubt about who I might be. Even as happy and upbeat as I was prior to surgery with Doug, the lines and curves in my face that didn’t belong to me abraded my confidence, were as wrong as a lock of hair that stands away from your scalp that no amount of coaxing can keep down.

I am sure that if Doug’s work did not exist, I would have made the best of it, but I suspect that as much happiness as I would have mined out of life, the difference between who I am and who my face said I was would have eaten away at me. Who knows.

Results aside, it allows me to not simply move through the world and society — the best I could hope for beforehand — but to actively embrace it, to find a peace within myself, or the possibility for it, that others see and perceive. It is a wonderful resonant cycle as the relaxed comfort in my own skin radiates from me to others, who in turn sense my centeredness and reflect happiness back at me.

It’s how I feel too. Undergoing this surgery has let me cross the line into my own womanhood in a way I could not quite manage before, no matter how well I did, how good I looked, and even then I could go to the women only sessions at the swimming pool and feel almost at ease. Now I am completely relaxed, found myself chatting to other women in the showers while we waited for one to be free the other day without me noticing what I was doing – an amazing feat of transformation when I think back to my early days.

There is a form of trasngendered political correctness in the USA these days which states that we should be accepted as we are, no matter how we are, this being our truth, this being one form of human existence the world needs to accept as another normalcy. We should be proud of who we are, no matter how we look.

Very good, but my own truth is that I am just a simple girl from Liverpool who wants to live without problem in this world; more than that, to live here with joy. I was like Dorothy in the Wizard of Oz – but I wanted to come home even more than she did. And I’ve made it, I’m back in Kansas, back in Brighton actually, just living in the world but now with restored exquisite normalcy. I am a very happy and fulfilled person, and my life is opening like a flower. What I have done, despite having no money to speak of, you can do too. Go for it.

The cost of the surgery with Dr Noorman van der Dussen, by the way, came to around £6,500. Not cheap, but a bargain in British or U.S. surgical terms. About a third of the cost here, if you could find the surgeon, and I don’t think he or she exists. I had SRS in Belgium too, under the kind knife of Dr. Seghers, a complete coincidence, so I know about Belgian medicine. It’s very good indeed, recommended.

By Persia West June 2001

Gender Trust – 2003, This information sheet is distributed by the Gender Trust and is intended as a basis for information only. The Gender Trust does not accept responsibility for the accuracy of any information contained in this sheet.


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