FFS Surgery Training for better gender-affirming treatment

People seeking facial feminization surgery typically do not identify with the gender assigned at birth. This is one of the main reasons why FFS surgery training and continuing education in the field of gender-affirming medicine is important. 

Most trans, non-binary or intersex children will know from an early age if their gender identity doesn’t fully match the labels and norms being applied to them.  Some will eventually choose to undergo varying degrees of a medical transition, from male-to-female or female-to-male, identifying more with the opposite gender. However, a growing group of non-binary individuals rejects the established “gender binary,” which is based upon just two social constructs –male or female.  In all cases, be it two-spirit, gender fluid, agender or gender queer, the TNBI community continues to struggle for access to properly trained medical care professionals.

The identified genital “sex”, as well as the secondary characteristics that develop during puberty, lead to clinically significant psychological distress, referred to as gender dysphoria in trans individuals. For binary patients opting for a gender transition, a complex and extended period is usually required that involves numerous diagnostic processes, medical-surgical treatments and extensive psychological care. All of this is aimed at allowing patients to achieve the physical expression of the gender with which they identify, with the intention of averting severe psychological conflicts, improving self-esteem and quality of life, and fostering the patient’s successful integration into the workplace, family and society.

According to multiple studies in self-perception and quality of life, gender affirming treatment such as facial gender confirmation surgery (FGCS) has produced clinically significant outcomes for patients.  The widely reported surge in demand for gender identity healthcare around the world has lead to an increase in the TNBI voices advocating for improvements in gender-affirming medical services.  Facialteam has grown in parallel, beginning with a team for scientific research, later opening its doors for surgical observerships and eventually launching its first accredited FFS Surgery training programs in recent years.   More good news is that academic institutions around the world are also building foundations for the training of a new generation of gender confirmation experts.

Education in facial gender confirmation surgery  – a growing field

As one of the fastest growing areas within plastic surgery, dissemination of education in gender surgery is essential to improving patient outcomes and stimulating technical innovations.

For this reason, Facialteam Training & Education is committed to the best quality care for the community. The events already organized by our T&E team, such as the FFS Webinar and the Facial Feminization Surgery Training Program celebrated in 2018, or the International FFS Workshop initiated in Spring 2019 are starting to resonate in the medical community.

To further our mission to advance education and quality training, we are proud to introduce this July 2019 in Baltimore, Maryland, USA – the first annual International Facial Gender Symposium. This symposium, born of an alliance between Johns Hopkins Center for Transgender Health and Facialteam Training & Education, is a collaboration to introduce innovations in techniques focused on improving facial gender congruence as well as encourage advancements in TNBI patient care. The symposium has been thoughtfully designed to maximize exposure to proven techniques by internationally and nationally recognized providers.

International Facial Gender Symposium, a new training platform for experts in facial feminization surgery

The symposium will be a high level, immersive 2-day program. It will include both theoretical sessions and a cadaver lab, where attendees will have the opportunity to practice key procedures in facial gender confirmation surgery. The program features invited lecturers of both international accolade and from practices across the United States, including medical directors from top centers across the country, such as Johns Hopkins Hospital, Oregon Health & Science and the Louisiana State University. IFGS is a space for facial and voice feminization experts to share experience and techniques, a landmark event forging a path for greater innovation in the field. These presentations are vital to continuing education and further our commitment to the educational mission of our centers.

On Friday, July 26, the theoretical day will take place. As a brief summary, we will go hand in hand with experts through the medical necessity of facial gender surgery; the surgical techniques, including forehead reconstruction, hairline management and transplantation, rhinoplasty techniques, midface management, jaw contouring, tracheal chondroplasty, voice therapy & surgical treatments; and how to use the latest technological and procedural medical advancements in the field of surgical feminization, such as ultrasonic technology as a cutting tool and ostectomy guides for lower jaw surgery.

On Saturday, July 27, 16 students will practice the surgical techniques on cadaveric specimens in the surgical facilities of the Johns Hopkins University Minimally Invasive Surgical Training and Innovation Center (MISTIC lab). You can see the entire program visiting

The program is designed for plastic surgeons, otolaryngologists and other craniofacial or maxillofacial specialists who keen to augment their knowledge of the surgical techniques involving bone and soft tissue specifically employed in facial gender surgery.

The symposium has been accredited by WPATH, so attendees may obtain Global Education Initiative (GEI) continuing education credits.

We are excited to celebrate what is sure to be a great learning experience and an event to help develop and advance patient care, particularly in the field of facial gender-affirming treatments.

Patient Relations Manager Lilia Koss, presentator of Lilia's Livestreams
About the author

Hello world! I’m Lilia Koss and I use she, her, and they pronouns. What are yours? With a background in humanities and diverse professional experiences, I have been working with the Facialteam founders and directors since 2018. Involved from the ground up, so I’ve had hands in many pots: patient coordination, orientation events on 3 continents, social media, written and audiovisual content about our gender-affirming healthcare...but now life is more defined. Lately, I focus my energies on Public Relations, community management and live streaming to help raise the visibility of trans health. Life is pretty complete.