How do we know what a woman looks like? Can we know someone is a woman just by looking at her face? For plastic surgeon Dr. Douglas Ousterhout, quoted above, the answer is self-evident: the size and shape of a woman's nose, forehead, chin, and cheekbones communicate her sex. As medical anthropologist Eric Plemons details in his rich ethnography, Dr. Ousterhout was a key figure in the development of the set of bone and soft tissue reconstructive procedures now referred to as facial feminization surgery (FFS). Plemons brings us into consultation and operating rooms in the San Francisco Bay area where FFS enacts a “trans- therapeutics,” his term for the implicit assumptions and explicit claims that support trans- medicine as a beneficial and therapeutic practice. Rather than focusing his ethnographic lens solely on the experiences or motivations of trans women who pursue...

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