A new report explains how dermatologists ‘are expanding their skill sets and exploring new techniques to enable gender-diverse patients to achieve their medical and aesthetic goals’.
A panel of experts who spoke at the American Academy of Dermatology 2021 Virtual Meeting Experience described how providing aesthetic procedures such as injectables and hair removal for lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) as well as sexual and gender minority (SGM) patients ‘requires more than medical and aesthetic expertise’ reported dermatologytimes.com.
Serving such patients ‘also demands an understanding of consent and medical insurance issues unique to these populations’.
Dr Meshkov Bonati noted even modest changes in a transgender, or gender transitioning, patient’s self-perception ‘can deliver major quality-of-life improvements. It’s important for us to recognise gender dysphoria is a classified diagnosis in the Diagnostic and Statistical Manual of Mental Disorders.’
Dr Bonati added gender dysphoria ‘is categorised as a feeling of distress that may occur in those whose gender identity differs from their sex assigned at birth or sex-related physical characteristics’, according to the Mayo Clinic, and ‘anywhere from 700,000 to 1.4 million Americans self-identify as transgender’.
She emphasised that, as with any patient community, caring for LGBTQ+/SGM patients ‘requires an understanding of that population’s holistic needs’ and dermatologists should be cognisant of the fact suicide rates among transgender individuals ‘greatly outpace those in the general population – 41% vs 4.6% – and quality of life improves for transgender people who have undergone transition.
Dr Bonati summed up: ‘What does that mean for a dermatologist who’s not performing these types of surgeries? We know there are approaches we can use to help the patient achieve a more masculine or feminine appearance.
‘We as cosmetic dermatologists can employ an injectable strategy that will enhance masculine or feminine features for the purpose of helping relieve the gender incongruity transgender patients feel.’
To explore the quality-of-life impact of injectable treatments in transgender individuals, Dr Bonati and colleagues undertook a pilot trial involving patients who had not previously undergone injectable treatments, which enabled patients to ‘pinpoint their gender self-perception before and after treatment compared to societal male and female ideals’.
She noted these patients were realistic: ‘They didn’t have wild expectations of having a brand-new forehead or jawline. They understood injectables can’t accomplish the dramatic results that can be achieved with surgery. So we shouldn’t be afraid to treat these patients.’
Post-treatment, patients achieved an average 44% shift toward gender ideals and ‘most patients reported reduced self-consciousness and embarrassment.’
Dr Bonati emphasised that ‘even more telling were the patients’ comments’; for example, one reported that friends noticed they were posting more frequently on social media, while others reported feeling more comfortable in gender-specific clothing and hairstyles.
Dr Bonati summed up: ‘One patient said, ‘I’m not sure if it’s the treatment itself or just knowing that I’m doing something that makes a difference.’ That’s what this is all about: empowering transgender individuals so they feel more in control of their gender and how they’re feeling, improving quality of life, and reducing suicidality.’ | AMP
