Associations Of Masculinity-Femininity, Facial Ratios, And Attractiveness: Insights From An Analysis Of 827 Individuals
Dillan F. Villavisanis, BA, Jessica D. Blum, MSc, Liana Cheung, MBBS, Daniel Y. Cho, MD PhD, Jesse A. Taylor, MD.
Children's Hospital of Philadelphia, Philadelphia, PA, USA.
PURPOSE: Males and females have known differences in anatomic facial features coding for sex, which are important for planning gender affirming facial surgery. This study hypothesized certain anatomic facial ratios are associated with perceptions of masculinity-femininity and sex. METHODS: This study used Chicago Face Database, a domain of facial measurements and metrics by 1,087 raters. Sex and ratings of masculinity-femininity were compared to facial anatomic indices, which characterized facial feature relativity (higher ratio scores indicated greater facial feature representation), including "nasal width ratio"=(interalar width)/(face width)*100, nasal length, eye height, eye width, forehead, lip, and chin. RESULTS: In 828 individuals, femininity was associated with eye height/width, lip, and nasal length indices, while masculinity was associated with chin, forehead, and nasal width indices (p<0.01). Among males alone (n=406), femininity was associated with eye height, lip, and nasal length indices; among females alone (n=421), masculinity was associated with nasal width and chin indices (p<0.01). Multivariate logistic regression models revealed nasal width and chin indices interact to predict male sex (OR=1.012,p=0.010), while nasal length and lip indices interact to predict female sex (OR=0.987,p=0.001). CONCLUSION: Our data suggest nasal length and lip indices interact to predict female sex while nasal width and chin indices interact to predict male sex. An understanding of these facial proportions may benefit those who perform facial feminization/masculinization surgery. 
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