Eric Plemons. The Look of a Woman: Facial Feminization Surgery and the Aims of Trans- Medicine. Durham, N.C.: Duke University Press, 2017. 208 pp.
Review by Sander L. Gilman
A revision of a dissertation written in anthropology at University of California, Berkeley under Cori Hayden, Eric Plemons’s study is a detailed account, using first-person interviews, of “facial feminization surgery,” a set of reconstructive procedures first developed in the 1980s. These procedures were initially seen as simply ancillary to genital sex-reassignment surgery for male to female transsexuals. Plemons, who is female to male transgendered, argues that such surgeries, given present day fluid notions of sex (not gender), have now come to provide an alternative to genital reconstruction. Being “seen” as female now provides a wide range of alternative means of new identity formation. The firsthand case material and in-depth interviews in this volume make it a valuable contribution to any methodological consideration of how surgical procedures can be seen as an extension not only of the surgeon’s craft but also of the patient’s desire.
Being “seen” is thus the core of Plemons’s work. As Rosemarie Garland-Thomson’s Staring: How We Look (2009) has well illustrated, one can indeed try to control the world by how one is seen in the world. Plemons observes “by the time most patients made the trip to the surgeon’s office, they had come to think of facial feminization surgery as enacting the change between the life they had and the life they wanted” (p. 113). Yet Plemons questions the surgeons’ goals rather than their surgical techniques. What is it to make one “look” feminine? When Plemons first observes the surgery and a surgeon proposes to him that he needs a more prominent Adam’s apple (p. 109), Plemons is startled by the notion that he does not look masculine enough after twenty years of hormone shots and extensive reconstructive surgery, including bilateral mastectomies. Can one ever “look” female or male enough for the world—or for one’s self?
At the core of this book is the Enlightenment debate about whether difference is fixed in the world (as Johann Gottfried Herder has it) or whether it is the product of our own struggle as humans, as "crooked wood," always trying to and needing to change (in the work of Immanuel Kant).1 Today it is not the theologian and the philosopher that engage in these debates but rather the surgeon and the anthropologist. Is the feminine or the masculine a fixed, visible quality in any given society? Or do we all constantly struggle to accomplish our sense of self?
What is striking about this book is that it proves the old adage that the carpenter sees everything in terms of hammers and nails; the surgeon sees the shaping of the body as fulfilling the desire of the patient for transformation, rather than as aiding the individual in a process of transformation. One might add that, as Plemons implies in his interlude on his own (missing) Adam’s apple, there is no end to such transformation. After you have an Adam’s apple (or once it is reduced in size), do you then need to go to the speech pathologist to work on the masculinization (or feminization) of your voice, and what does that actually mean in any given context? This is a well-written and thought-provoking contribution not only to transgender studies but also to our debate about how we necessarily and constantly refashion ourselves.
1. Immanuel Kant, Religion within the Limits of Reason Alone, trans. Hoyt W. Hudson and Theodore Greene, in Basic Writings, trans. Hudson et al., ed. Allen W. Wood (New York, 2001), p. 411.