Gender-affirming facial surgery: Anatomy and fundamentals of care

Caring for patients who identify as transgender and gender diverse (TGD) requires a ground level understanding of proper patient communication, a framework for decision-making surrounding medical and surgical interventions, and an awareness of obstacles surrounding healthcare. The objective of this chapter is to highlight appropriate terminology and definitions, discuss the current standards of care for transgender health, raise awareness of the barriers to healthcare access facing the TGD population, and discuss basic facial anatomy and sexual dimorphisms. Gender incongruence occurs when birth-assigned sex and gender identity differ for an individual, and gender dysphoria is the distress felt in this state. Persons who experience gender dysphoria may seek gender-affirming hormone therapy or surgery. Access to care is not straightforward, and the current standards of care aim to provide a guideline for administration of hormones and surgery. In order to offer the highest level of care, surgeons should have a fundamental understanding of issues surrounding the TGD community combined with a robust comprehension of facial features characterizing gender.