Most dermatologists have not historically considered their patients’ sexual orientation and gender identity as relevant to their practice, but new data contributes to awareness in skin health disparities in patients from sexual and gender diverse (SGD) communities.
Dermatologists who strive to understand their patients can better see them as a whole person, engage in a better differential diagnosis, be more aware of the current comorbidities SGD patients face that affect dermatologic disease, and can even work with the patient toward preventative dermatologic care. Currently, the most important message is for dermatologists to recognize that exceptional dermatological concerns exist in SGD communities. These include:
- Higher risk of skin cancer and indoor tanning in gay and bisexual men
- Acne and hair concerns in transgender persons undergoing gender-confirming treatment
- Transgender patients undergoing masculinizing hormone therapy with testosterone often have acne, which could be disfiguring and could worsen over time
- Transgender patients undergoing feminizing hormone therapy often continue to have facial hirsutism or pseudofolliculitis barbae despite optimized hormone therapy
- Transgender patients seeking genital surgery will also require permanent hair removal for surgical flap/graft preparation
- Higher burdens of skin cancer, sexually transmitted disease (STD), and complications associated with hormone therapy or gender-confirming surgery
- Higher likelihood of suffering from mental illness and suicidal ideation
- Dermatological sequelae may include classical manifestations of androgen excess from hormone therapy such as acne and androgenic alopecia; acne, miliaria, tinea corporis, contact dermatitis from chest binding; and surgical scars and keloids
- Melasma or asteatotic eczema while receiving estrogen therapy; unwanted facial or body hair; and complications from illicit injections that may cause foreign-body granulomas, bacterial or atypical mycobacterial infection, lymphedema, and scarring
- Transgender patients may choose to undergo aesthetic treatments to confirm their gender and decrease their gender dysphoria, augment the effects of hormone therapy and gender-confirmation surgery, and improve their quality of life
Creating an inclusive environment is key to successfully caring for SGD patients. Read the American Academy of Dermatology’s position statement addressing SGD health in dermatology.
LiVDerm Deep Dive: Dermatologic Care in the Sexual and Gender Diverse Patient
Medical and aesthetic dermatologists who understand that SGD patients face a complex and unique set of medical needs are not only at the forefront of compassion and acceptance, they are also a much-needed ally for this patient community. But understanding the need and wanting to meet it is just the beginning – they need the tools, expertise, education and skills to provide these services and procedures to patients in the SGD community.
Always looking to the future of dermatologic industry needs, LiVDerm’s collection of educational offerings has expanded to include a 7-hour program on the most important topics in delivering the best care to SGD patients. This thoughtfully curated course takes learners through relevant health concerns such as hormone-related acne and hair loss, contraceptives, gender-confirming surgery and aesthetic modifications, STD and cancer screening, and much more.