Podcast Summary: “A Trans Woman Finds Her True Face Through Surgery”
The New Yorker Radio Hour – April 17, 2018
Host: David Remnick
Reporter: Rebecca Mead
Episode Overview
This episode of The New Yorker Radio Hour, hosted by David Remnick and reported by staff writer Rebecca Mead, follows the story of Abby, a trans woman undergoing facial feminization surgery (FFS). Through in-depth narration and first-person accounts, it explores both the emotional landscape of gender dysphoria and the physical, psychological, and social ramifications of surgical transition. The episode provides a rare look inside a surgical theater and examines the nuances of identity, visibility, and acceptance as experienced by trans individuals.
Key Discussion Points & Insights
1. Introduction: Entering the Operating Room
- [01:09-01:49] Rebecca Mead describes her experience observing Abby’s surgery for the first time, noting her own squeamishness and the oddly soothing Brit pop playlist in the background.
- Abby, under sedation, undergoes an initial incision to reduce her Adam’s apple, marking the first of several key procedures.
2. Abby’s Motivation and Dysphoria
- [02:05-04:50]
- Rebecca first interviews Abby via Skype—Abby reflects on her facial features, expressing particular discomfort with the side profile and the masculine cues of her brow and Adam’s apple.
- Quote:
“With something like facial features, those are chiefly defined by the size and proportions of the bones. You know, your facial bones developments during puberty. For me, that I just can't, I can't undo.”
— Abby (02:50) - Although hormone therapy and social transition steps had brought Abby closer to her identity, persistent facial cues undermined her sense of self.
- Abby describes the subtle signals that faces convey and how not meeting those expectations led her to withdraw socially, changing even her mannerisms to mask discomfort.
3. Visibility, Safety, and Social Scrutiny
-
[04:50-05:37]
- Abby discusses the heightened visibility and resultant scrutiny faced by trans people, noting increased public attention can feel voyeuristic.
- Quote:
“Now I think there’s just more scrutiny ... Is that one of the people that I’ve heard about in the news?... And we don’t want that attention.”
— Abby (05:13)
-
Abby’s desire for privacy and safety informs her decision-making; she uses a pseudonym and is acutely aware of violence against trans people.
4. The Surgeon’s Approach: Science & Art
-
[05:37-10:06]
- The surgery, performed by Dr. Deschamps Braly, is shown as highly technical and artistic, involving millimeter-precise bone reduction, reshaping, and reassembly.
- Rebecca paints a vivid, clinical picture:
- Removal of the brow ridge
- Peel of the forehead “like the skin of a mango”
- Jaw and chin reduction
- Quote (Rebecca Mead, on the surgery):
“Her forehead is now being lifted off her scalp and folded down over her eyes... It starts to feel rather like a science fiction movie.” (07:44)
-
Rebecca questions whether FFS is "beautification surgery".
- Quote:
“To an extent it is a little bit of a beautification ... But my motivations just aren't cosmetic... it’s to relieve dysphoria, to help the world see me as who I am.”
— Abby (10:06)
- Quote:
5. Understanding Gender Dysphoria
-
[10:40-11:57]
- Rebecca explains gender dysphoria as a “severe dislocation between one’s inward sense of self and one’s outward appearance.”
- Abby and a companion describe the psychological dissonance:
- Quote:
“You have this really strong mental image... and then when you look in the mirror... it projects the extreme opposite... can feel just extremely intense and extremely negative emotions ... completely debilitating, completely crippling.”
— Abby & Companion (11:13-11:57)
- Quote:
-
When asked what Abby hopes to see post-surgery:
- Quote:
“Myself.”
— Abby (12:05)
- Quote:
6. The Surgical Process in Detail
- [12:10-13:53]
- The seven-hour surgery continues:
- Jaw and chin are reshaped, bone pieces are removed and rejoined for a smaller, more feminine contour.
- Rebecca notes the intense physicality and force involved.
- The seven-hour surgery continues:
7. Abby’s Recovery and Psychological Outcome
-
[13:53-16:19]
- Five weeks after surgery, Rebecca visits Abby, who is back at work and has shared her experience with only a few trusted colleagues.
- Abby keeps a piece of removed bone in a plastic container as a memento.
- Immediate emotional reactions differ among patients; while some experience tears or shock, Abby reports a quiet acceptance.
- Quote:
“Finally when she looked in the mirror... she thought, oh, yeah, that’s my face.”
— Rebecca Mead (16:07)
-
Discussion about how trans patients often accept their new faces more readily than cis patients after facial surgery:
- Quote (Companion):
“With their trans patients... It’s just like, oh cool. It’s just, it’s like over and done. Their trans patients just tend to just to accept... their quote unquote new face.” (16:19)
- Quote (Companion):
Notable Quotes & Memorable Moments
-
On Bone Structure and Gender Aesthetics:
“Those are chiefly defined by the size and proportions of the bones... For me, that I just can't, I can't undo.”
— Abby (02:50) -
On Social Scrutiny:
“Now I think there's just more scrutiny... Is that one of the people that I’ve heard about in the news?... It’s kind of voyeuristic and we don’t want that attention.”
— Abby (05:13) -
On the Surgery Experience:
“Her forehead is now being lifted off her scalp and folded down over her eyes. Dr. Deschamps Braly... draws the shape of the planned incision... It starts to feel rather like a science fiction movie.”
— Rebecca Mead (07:44) -
On Motivation for Surgery:
“...my motivations just aren't cosmetic. My motivations aren't superficial. For is to relieve dysphoria, to help the world see me as who I am.”
— Abby (10:06) -
On Dysphoria:
“Dysphoria is ... the difference between not really liking your thighs and feeling like your thighs do not belong to you.”
— Rebecca Mead (10:40) -
On Seeing Herself Post-Surgery:
“Myself.”
— Abby (12:05) -
On Emotional Adjustment:
“It’s amazing to see you because you look... It’s just—”
“What are your impressions?”
“You look well, you look lovely.”
— Rebecca Mead & Abby (14:41-14:54)
“...you look familiar and yet not the same. I think you look more different than I thought you were going to.”
— Rebecca Mead (15:01) -
On Acceptance of “the new face”:
“With their trans patients ... it’s just like, oh cool. It’s just, it’s like over and done.”
— Companion (16:19)
Timestamps for Key Segments
- [01:09] – Surgery begins; Adam’s apple reduction
- [02:05] – First Skype interview with Abby; her feelings about her features
- [03:43] – Social withdrawal, changing mannerisms from dysphoria
- [04:50] – On trans visibility and scrutiny
- [06:54] – Surgeon’s tools and pre-operative planning
- [07:44] – Dramatic description of brow surgery
- [10:06] – Abby on motivations: cosmetic vs. gender affirmation
- [10:40] – Defining gender dysphoria
- [11:57] – Hopes for life after surgery: “Myself”
- [12:10] – Jaw and chin surgery in detail
- [13:53] – Five weeks post-surgery; Abby’s recovery and emotional outcome
- [16:19] – Ease of social/psychological adjustment among trans patients
Closing Thoughts
Through the lens of one woman’s intimate experience, this episode captures the complexities and deeply personal stakes of facial feminization surgery. The conversation goes far beyond the surgical table, delving into issues of safety, identity, social perception, and the lived realities of trans Americans. Carefully crafted reporting and candid, often moving commentary from Abby provide a nuanced, humanizing portrait of medical transition—grounded in science, but ultimately about self-recognition and belonging.