Gender Identification

The process for a young person who does not identify with their assigned sex at birth and is seeking gender-affirming surgery is typically structured over multiple stages to ensure medical, psychological, and legal readiness. The details can vary depending on the country and local laws, but here is a general outline of the journey from self-discovery to surgical care.

At Dr. Kriya Gishen's Beverly Hills practice, we understand that this journey is deeply personal. As an Ivy League-trained, UCLA fellowship-trained plastic and reconstructive surgeon specializing in craniofacial surgery, Dr. Kriya provides compassionate, expert care for patients seeking gender-affirming facial procedures.

The young person often begins by recognizing their gender identity and expressing it in non-medical ways, such as adopting a new name, pronouns, clothing style, or hair presentation that aligns with their gender identity. They may involve their family, friends, schools, and sometimes support groups or LGBTQ+ organizations.

Usually, a mental health professional (psychiatrist, psychologist, or gender therapist) becomes involved early to confirm a gender dysphoria diagnosis (if present) and to assess the young person's emotional and psychological readiness. Counseling often continues throughout the process, providing support during transition.

Adolescents may be prescribed puberty blockers if they are early in puberty. These blockers pause unwanted physical changes, giving time to make informed decisions about next steps.

Later on, gender-affirming hormone therapy (estrogen or testosterone) may be introduced, usually with parental consent for minors. Endocrinologists and pediatric specialists are often involved to monitor health and development.

Most countries and medical guidelines (such as WPATH — World Professional Association for Transgender Health) recommend that genital surgeries are not performed until age 18 or older. Chest (top) surgery may be allowed earlier in some contexts (often around age 16–17 with parental consent).

Requirements typically include:

• Persistent and well-documented gender dysphoria
• At least 12 months of hormone therapy (for some surgeries)
• At least 12 months of living in their affirmed gender role (sometimes required)
• Mental health professional(s)' letters of recommendation (often 1–2 letters)
• Medical clearance for physical health

Parental or guardian consent is usually required for minors. In some regions, court approval may also be necessary. Legal name and gender marker changes may be pursued alongside medical steps.

After meeting the readiness criteria, the patient is referred to a surgeon specializing in gender-affirming procedures. The specific procedures vary based on the patient's desired outcome and may include:

Either mastectomy (for transmasculine patients) or breast augmentation (for transfeminine patients).

Options include vaginoplasty, phalloplasty, or metoidioplasty, depending on the patient's goals.

Facial feminization surgery is one of the most impactful gender-affirming procedures available. FFS addresses the bony and soft tissue structures of the face that are most associated with gender perception — including the forehead, brow ridge, nose, jaw, and chin.

Dr. Kriya Gishen is uniquely qualified to perform FFS due to her UCLA craniofacial fellowship training, which focused specifically on facial bone surgery. Her use of virtual surgical planning with CT scans allows her to map precise bone modifications before surgery, delivering predictable and beautiful results.

Common FFS procedures include:

• Forehead contouring and brow bone reduction
• Rhinoplasty (nose reshaping)
• Jaw and chin recontouring
• Cheek augmentation
• Brow lift and eyelid surgery
• Lip lift
• Tracheal shave (Adam's apple reduction)
• Hairline lowering

Other gender-affirming procedures may include body contouring, voice surgery, and non-surgical rejuvenation treatments to complement surgical results.

Post-surgical follow-up is essential for physical recovery, hormone management, and ongoing psychological well-being. At Dr. Kriya's Beverly Hills practice, patients receive comprehensive post-operative care including regular follow-up appointments, pain management guidance, and access to supportive resources throughout their recovery.

Choosing the right surgeon for gender-affirming facial procedures is one of the most important decisions in the transition journey. Dr. Kriya Gishen brings a unique combination of qualifications:

• Ivy League education providing a rigorous academic foundation
• UCLA craniofacial fellowship specializing in facial bone surgery
• Fine arts and sculpture background giving her an exceptional eye for facial aesthetics and proportions
• Virtual surgical planning using CT scans for precise, predictable results
• Compassionate, patient-centered care in a welcoming Beverly Hills environment

Schedule a consultation with Dr. Kriya Gishen — call (310) 890-7262 or contact us online to begin your journey toward the face that reflects your true self.

Facial feminization surgery is typically performed on adults (18 and older), though some procedures may be considered earlier on a case-by-case basis with appropriate medical and psychological evaluations and parental consent. During a consultation at Dr. Kriya's Beverly Hills office, she can discuss age-appropriate options and timing.

The timeline varies depending on individual readiness, insurance requirements, and the specific procedures planned. After an initial consultation with Dr. Kriya, the process typically involves CT scan imaging, virtual surgical planning, medical clearance, and scheduling. Many patients are able to proceed within a few months of their initial consultation.

Many insurance plans now recognize facial feminization surgery as medically necessary for the treatment of gender dysphoria. Dr. Kriya's Beverly Hills team can help you understand your insurance benefits and explore coverage options during your consultation.

Most patients can return to daily activities within 2–3 weeks, though complete healing takes several months. The initial swelling and bruising typically subside within the first few weeks. Dr. Kriya's craniofacial expertise allows her to provide detailed, procedure-specific recovery timelines during your consultation.

Yes, FFS can sometimes be combined with other procedures such as tracheal shave, rhinoplasty, or brow and eyelid surgery in a single surgical session, reducing overall recovery time. Dr. Kriya will discuss the safest and most effective surgical plan during your Beverly Hills consultation.