This chapter is set inside the operating room, where the act of facial feminization surgery is constituted by tensions between the abstract tools of gender theory and the visceral materiality of reconstructive surgery. Through interspersing detailed field notes of one patient’s operation within an analytic exploration of the place that trans- bodies have occupied in gender theory, the chapter explores tensions between the body in books and the body on the table. It is ethnography that provides a meeting place between the two, insisting that it is in the situated practices of living that bodies, like ideas, acquire potential and meet their limits. Cutting, sawing, and suturing are examples of potential and limit, both for the ethnographer and for the patient whose deeply intimate transformation was witnessed.