Transgender, gender-diverse individuals report acne-related stigma

Transgender and gender-diverse individuals report experiencing acne-related stigma, according to a study published online Jan. 3 in JAMA Dermatology.

Sarah Gold, from the Emory University School of Medicine in Atlanta, and colleagues conducted a mixed-methods analysis at a multidisciplinary gender center using semistructured interviews and surveys to examine the lived experiences of acne and acne treatment in transgender and gender-diverse participants. Thirty-two individuals were included in the study: 17 transgender men, 11 transgender women, and four nonbinary participants.

The researchers found that 10, 11, and 11 participants self-rated their skin as currently clear or almost clear, with mild acne, or with moderate-to-severe acne (31, 34, and 34 percent, respectively).

Experiences of rejection and bullying related to acne were described, and participants admitted avoiding social interactions in which they expected acne-related discrimination, which led to depression and anxiety.

Body appearance dissatisfaction was worsened with acne. Transgender women reported that acne interfered with feminine gender expression, while transgender men frequently normalized acne development, perceiving it as a sign of testosterone action.

Most of the participants tried over-the-counter treatments for acne; acne treatment advice was commonly sought from physicians, peers, online forums, and social media. Cost, lack of multidisciplinary care, mistrust toward the health care system, and lack of transgender-specific acne care education were barriers to acne treatment.

"Clinicians should proactively inquire, monitor, and treat acne to take the onus off the patient and facilitate acne care and should develop further research to guide evidence-based hormonal acne treatment," the authors write.

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