Trans and gender diverse (TGD) individuals experience a deep sense of self-discrepancy between their actual self and their idealized or ought self. This self-discrepancy motivates a non-negotiable drive to bring the actual self into closer alignment with an ideal or ought self. Gender-affirming facial surgery (GFS) is one of the most popular types of gender-affirming surgical procedures among trans women to decrease self-discrepancy. Importantly, following good surgical outcomes, research supports both emotional and social benefits of facial feminization surgery (FFS), as it reduces gender incongruences that are driven by self-discrepancies. However, more research is warranted. The empirical literature lacks an acknowledgment of the systemic barriers to care as well as the numerous institutionalized cultural biases for standards of beauty and access across both patient race and language needs. Greater attention should be given to patients served in the public health systems, and efforts should be expanded to advocate for service access. Collaborations between surgical teams and patient advocates or peer resource navigators should be strengthened to ensure that socially underserved patients have equal access to medically necessary GFS services and have the necessary resources and social support for resilient wellness and post-surgical recovery.