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As the principal authors of the paper by Fisher et al, 1 we would like to thank Dr Persing and Ms Ching for their insightful letter 2 and for bringing attention to Ching et al’s study,“Perception of Femininity and Attractiveness in Facial Feminization Surgery.” 3 This study is interesting for 2 reasons:(1) the authors shed light on how manipulation of certain facial features affects perceived femininity; and (2) data collected from both transgender and cisgender females provide insight from 2 distinct perspectives. In their study, Ching et al used images of the nasal tip width, supratip angle break, and mandibular gonial angle of cisgendered males that were digitally modified to appear progressively more feminine. The authors collected responses with regard to gender perception from transgender females, cisgendered males and females, and plastic surgeons. This enabled them to compare perceptions of femininity of various …