Olympic gold medalist and popular TV personality, Caitlyn Jenner, came out to ABC’s Diane Sawyer on Friday night that she is transgender, confirming years of rumors that she is undergoing a gender transition.
“For all intents and purposes, I am a woman,” Jenner, 65, states. “My heart and soul — everything that I do in life — it is part of me. That female side is part of me. That’s who I am.”
Jenner’s public interview is finally shedding much-needed awareness and education on the topic. But for the general public, gossip, media speculation and overall lack of understanding have led to many harmful misconceptions about transitioning and marginalized the transgender population. We spoke to three plastic surgeons, all who specialize in facial feminization surgeries and see transgender patients, to dispel some of the most common myths.
Transgender people are not confused about their gender — in fact, it’s quite the opposite. “Transgender women or men know of their gender for years — specifically since they’re about the age of 6,” says Boston plastic surgeon Jeffrey Spiegel MD. “The challenge is that while they know their true gender, they are unable to have others recognize them and see them for who they know they are.” Jenner said he was about 8 or 9 when he first knew.
“However, while a person may know for a very long time or their entire lives that they are a trans person, it might take them 40 or 50 years to admit that because of the social implications that may have,” explains San Francisco Plastic and Craniofacial Surgeon Jordan Deschamps-Braly M.D. “It is a very heart-wrenching thing because feeling stuck in one’s own body is one of the most unrelenting psychological forces in someone’s life. Nothing that makes that go away and people bury it for years and years.”
For adult males transitioning to females, hormones alone make little impact on the overall physical feminization of the person, says Dr. Spiegel. “What makes a face appear feminine versus masculine is all in the bone structure, so surgery is required in order to reconstruct the face to eliminate the features that are perceived as masculine and reshape them to feminine.”
“The most feminizing and youth-producing procedures are to move the hairline forward, lift the brows and flatten the supraorbital rims,” explains Beverly Hills surgeon Toby Mayer, MD. “Most patients also undergo rhinoplasty in order to re-sculpt the nose to make the bridge straighter and the tip more refined. Finally the jaw and chin need to be re-contoured and the Adam’s apple removed.”
“Patients can also elect to undergo cheek and lip enhancements to give both a rounder and smoother appearance,” adds Dr. Deschamps-Braly. “Cheek augmentation could entail either inserting implants underneath the skin or volumizing the area with fat injections. Lip work could include either a lip lift, which shortens the upper lid and the use of fillers or fat transfer injections for plumping the lip.”
“There aren’t any rules around what has to be done in order to transition from a man to a woman,” says Dr. Deschamps-Braly. “One can choose to undergo a number of procedures including hormone therapy, , genital gender reassignment, or facial feminization surgery. However, there are no required procedures. About half of all transitioning patients elect only to undergo facial reconstruction surgery, because that is all that is needed in order for the general public to perceive them the way that they identify themselves.” breast augmentation
“It’s a big misconception that one changes into a completely different person after transitioning,” says Dr. Spiegel. “Instead, what happens is that transitioning allows the person feel whole and finally look the way that they feel inside. It empowers patients to be able to choose how they live the next stage of their lives. It allows people to live their lives successfully as who they actually are.”
“It’s an unfortunate stereotype that trans people live in or come from some sort of underworld or different world than everyone else,” says Dr. Deschamps-Braly. “In reality, the vast majority of patients that we see transitioning are highly educated and highly functioning individuals with enormous amounts of qualities to give to the world. They’re bankers, CEOs, engineers — they come from all walks of being successful.”
“I see about 10 patients a week that are transitioning,” adds Dr. Mayer. “There’s nothing odd or weird about it. One doesn’t choose to be male or female — it chooses them. The bottom line is: Many may look at Bruce Jenner the Olympian who once graced a Wheaties box and ask ‘Why would a guy like him do this?’ And the answer is, because he is not happy and he will only be happy when he’s a woman.”
In Jenner’s own words: “I’m emerging as myself. Isn’t that great?”
To make an appointment with Dr. Deschamps-Braly, please contact our San Francisco office +1.415.624.3922.