This chapter leaves the surgical clinic to examine contexts in which claims to the therapeutic efficacy and transformative capacity of facial feminization surgery are explicitly refused. While patients who seek FFS are driven by a desire to be recognized as women, neither forms of recognition nor the category “woman” are limited to individuals alone. Some critics see FFS as capitulating to demands that trans- women reproduce normative femininity and that FFS patients’ value for individual recognition as women undoes the political potential of making space for gender difference by making that difference visible. The state also refuses to recognize the transformation enacted by FFS, as legal definitions of sex and surgical sex reassignment overwhelmingly remain centered on genitalia. By engaging the complexities of recognition over the dichotomy of passing and not passing, this chapter contends with the effects of FFS beyond the individuals who undergo it.