Standards and Strategies in Facial Feminization Surgery

During Herbert Hoover’s presidential administration, American research institutions were charged with increasing research on what Hoover called “normal children.” Departments of Dentistry and Orthodontics at ten major universities responded to this charge by conducting long-term studies of craniofacial growth and development. While the studies’ express aim was to provide metric standards of normal craniofacial development that could guide orthodontic interventions, decades later, one study, the University School Growth Study (USGS) conducted at the University of Michigan, was put to a very different use. Held as the definition of normal facial structure, the metrics of the USGS were used to guide the development of facial feminization surgery (FFS), a set of bone and soft tissue reconstructive procedures intended to feminize the faces of transgender women. In this talk I trace the will to standardization as a vital strategy for legitimization in the disputed practice of facial sex change. When claims to the metric norms of osteological sex replace shifting and context-bound understandings of “masculinity” and “femininity,” standard forms become strategies for embodied surgical work. I engage the history of FFS as an example of how standards move and acquire new power, and make links to ongoing research in the US and Europe aiming to determine new definitions of facial sex and new plans for facial feminization surgery.