According to Cox, her decision not to undergo facial feminization surgery — a series of procedures aimed at adding traditionally feminine features to the face — has also helped her feel more comfortable in her skin. "What I know now is that if someone can look at me and realize that I’m trans, then that’s a beautiful thing, because trans is beautiful," Cox says. "Transition is about making your outsides and insides match... Sometimes it’s not about going to the plastic surgeon to fix things. The plastic surgeon can change what’s on the outside, but you still need to do work to improve the inside."