Male-to-female transgenders demonstrated unique perspectives on perceived facial attractiveness and orthognathic surgery need

Purpose

The esthetic preference and decision concerning undergoing orthognathic surgery in the transgender population have not been reported. The aims of this study were to examine the influence of the sagittal mandibular position on the esthetic perception and perceived surgery need in male-to-female transgenders (MTFTs) compared with male and female laypeople.

Materials and Methods

A questionnaire study was performed by male-to-female transgender, male and female laypeople. Three-dimensional black & white male and female facial images with facial contour angle (FCA) of 3°, 1°, 5°, 9°,13°, 17°, and 21° were shown to the participants. The participants scored the images’ perceived facial attractiveness using visual analog scales (VAS) and indicated whether orthognathic surgery was needed.

Results

The participants included 85 MTFTs, 85 males, and 85 females. The results revealed that there were significant differences in the VAS scores between the MTFT and male participants. The MTFTs rated the male images with prognathism of 1° and -3°FCA in significantly lower scores compared with the males (P = 0.033, P = 0.010). Female images with prognathism 1°FCA was rated by the MTFTs in significantly lower scores compared with the males (P = 0.041). A significantly higher number of surgery needs was found in the MTFTs compared with the other groups.

Conclusions

Gender influences esthetic perception and the decision to undergo orthognathic surgery. MTFTs have a unique perspective on facial esthetics, being more desirous of surgery than males and females. Clinicians should be aware of the ideal expectation in facial esthetics in MTFTs.