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The goal of facial feminization surgery (FFS) is to feminize the sexually dimorphic characteristics of the face and enable transwomen to be correctly gendered as female. Studies have demonstrated high patient satisfaction with FFS. However, the correct gendering of patients after FFS has never been objectively studied.

The aim of this study was to determine if FFS changed the perceived gender of patients in the public eye.

An online survey platform with control photographs of cis-gender males and cis-gender females as well as preoperative and postoperative FFS patients was created. Respondents were asked to identify patients as “male” or “female” and to assign a confidence score ranging from –10 (masculine) to +10 (feminine) (n = 802).

Cis-gender male and female controls were gendered …