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Douglas Ousterhout: my overview (1998)

Below are additional materials I had published online in the 1990s about pioneering surgeon Douglas Ousterhout. Preserved here for historic interest.

Information and patient experiences with Douglas Ousterhout


In summer 1996, I began researching the possibilities available for facial surgery I sought. I wrote to Dallas Denny at AEGIS for recommendations, and she sent back two names of doctors who had specialized to some degree in facial feminization: Toby Mayer at the Beverly Hills Institute of Aesthetic and Reconstructive Surgery, and Douglas Ousterhout in San Francisco. I wrote to both for information and was impressed in different ways.

While I was waiting for the info to come, I had consultations with several Chicago plastic surgeons, all of whom I found completely unimpressive and clueless about what I wanted done. At $75 to $150 a pop for consults and tens of thousands for surgery, I wasn’t going to waste any more time consulting with surgeons who had not had considerable experience with transsexuals.

I had actually heard of Toby Mayer for his innovation in a hair replacement procedure called the Fleming-Mayer flap. The folder of information they sent was very professional, very slick, and very thorough. It had a lot of information for general patients, and a very good article by Dallas Denny on the specifics of facial work for TSs, originally published in Chrysalis Quarterly.

Dr. Ousterhout sent me his informative “Feminization of the Transsexual” brochure, along with a letter requesting a consultation in person along with x-rays before he could make specific recommendations and comments. This made a lot of sense to me. I began researching both physicians’ published work and was deeply impressed with a book on plastic surgery Dr. Ousterhout had edited and contributed to. It was from that book that I decided on a consultation with him first. Once I had that, I was certain I was going to him.

Dr. Ousterhout’s practice

Dr. O. has a practice that encompasses many varied cases: men and women of all ages, children, people who have been in accidents, people with birth anomalies and bone deformities of the face, etc. In fact, he spends much of the summer in Sacramento doing work on kids. A pretty amazing guy, I thought.

At the time I went in, Dr. Ousterhout’s practice was approximately 10% TS by his estimate. He told me in 1999 that it was about 50%. I believe that probably makes him one of the most experienced surgeons with facial feminization, along with Meltzer and Schrang. To me, that is very important. Those wishing to see photos of my results should paste the following into their browser:

1999 update

I had my jaw and nose done in late 1997, just prior to coming out at work in early 1998.While the facial surgery was just part of the reason I think I’ve had good fortune in my transition, I feel my ability to pass made everything much easier. I believe this allowed me to keep my job and have a smooth transition without bathroom issues and other common workplace problems. I also believe it allowed me to get my SRS moved way up to four months after going full-time. Finally, I believe it allowed me to go through life without facing the sort of harassment and ridicule that I had seen decimate the self-esteem of some non-passing TSs I knew.

2001 update

It took me several years, but I’ve now paid off all the debt I incurred to my face work. I still contend it was the most important thing I did in transition. I honestly feel that I would not have had the success I’ve had in my career and social life had I not done this.

Other patient experiences with FFS and/or Dr. Ousterhout

Since I wrote my own account, others have added their own stories. Dr. Anne Lawrence maintains a collection of links to other TS facial surgery patient experiences, notably those of LynnBeckyMadeleineNickiRandi and Sally, all of whom are patients of Dr. Ousterhout.

I never would have gone to San Francisco if I hadn’t written to Dallas Denny in 1996, who mentioned two surgeons on the west coast. So those who write to thank me should also thank Dallas!

My experiences with Douglas Ousterhout

Please note that many things have changed since I had FFS in 1996. Back then, there was no Cocoon Guest House, the hospital had a different name, and you did your recovery in an empty wing of the hospital or at local hotels.

I have left my own experiences available here for historical interest. Do not use my information to plan costs or other practical matters. Those are best handled by contacting Dr. Ousterhout’s office directly.

Dr. Ousterhout and Cocoon Guest House:

Frequently-asked questions

I’ve compiled answers to the common questions I get. Please read all my information before sending me a question.

How much did you pay?

  • See my page on costs.

Does Dr. Ousterhout require a therapist’s letter?

  • No.

Did people at work notice?

  • Not really, but I was careful to conceal things by wearing a baseball cap.

How was scarring?

  • Not noticeable after several months

How was numbness?

  • Fine after several months, although there’s still change in sensation I expect will be permanent. Doesn’t bother me, though.

Do you have to stay after surgery?

  • Check with him.

Does he do voice surgery?

  • No.

Does he do SRS?

  • No.

Does he offer financing?

  • Check with him.

Does he take credit cards?

  • Yes.

If I send you a photo will you tell me what I need done?

  • Reluctantly.

Did your voice change?

  • No.

Should I do SRS or face?

  • I recommend face for better day-to-day benefits.

I got an estimate from Dr. ___ for ___ work, and his estimate was $____. Should I do it?

  • I can’t answer that.