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Akhavan AA, Pang JH, Morrison SD, Satterwhite T. Gender Affirming Facial Surgery-Anatomy and Procedures for Facial Masculinization. Oral Maxillofac Surg Clin North Am 2024; 36:221-236. [PMID: 38458858 DOI: 10.1016/j.coms.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
For some patients, feminine facial features may cause significant gender dysphoria. Multiple nonsurgical and surgical techniques exist to masculinize facial features. Nonsurgical techniques include testosterone supplementation and dermal fillers. Surgical techniques include soft tissue manipulation, synthetic implants, regenerative scaffolding, or bony reconstruction. Many techniques are derived from experience with cisgender patients, but are adapted with special considerations to differing anatomy between cisgender and transgender men and women. Currently, facial masculinization is less commonly sought than feminization, but demand is likely to increase as techniques are refined and made available.
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Affiliation(s)
- Arya Andre Akhavan
- Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Suite E1620, Newark, NJ 07103, USA; Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA
| | - John Henry Pang
- Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA
| | - Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356165, Seattle, WA 98195, USA
| | - Thomas Satterwhite
- Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA; Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center.
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2
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Mark I, Diaz MJ, Tran JT, Lipner SR. There Exist Educational Deficiencies in Specialized Dermatologic Care: Implications for Patients of Different Sexes, Genders, and Sexual Orientations. Dermatol Pract Concept 2024; 14:dpc.1402a128. [PMID: 38810032 PMCID: PMC11135945 DOI: 10.5826/dpc.1402a128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 05/31/2024] Open
Affiliation(s)
- Isabella Mark
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael J. Diaz
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | | | - Shari R. Lipner
- Department of Dermatology, Weill Cornell Medicine, New York City, USA
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3
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Roszell K, Shumer D, Orringer J, Wang F. Limited health insurance coverage of injectable neurotoxins and fillers for gender affirmation: a cross-sectional study of Affordable Care Act silver and Medicaid plans. Int J Womens Dermatol 2024; 10:e126. [PMID: 38313363 PMCID: PMC10836869 DOI: 10.1097/jw9.0000000000000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/23/2023] [Indexed: 02/06/2024] Open
Abstract
Background Injectable neurotoxins and fillers are potential options for facial gender affirmation for transgender/nonbinary patients. However, the largest barrier to access is cost/insurance coverage. Objective The purpose of this article is to assess the extent to which Affordable Care Act (ACA) silver plans and Medicaid policies cover gender-affirming injectable neurotoxin and filler procedures. Methods A cross-sectional study of all ACA silver plans and Medicaid policies was performed from June 22 to August 15, 2021. Plan-specific certificates of coverage, clinical policies of insurance providers, and Medicaid documents were evaluated. Results A total of 915 plans were reviewed (864 ACA silver plans and all 51 Medicaid policies). None potentially covered neurotoxins. Only 72 (71 ACA and 1 Medicaid) potentially covered fillers, specifically collagen injections and lipofilling. Coverage required demonstration of medical necessity or significant variation of physical appearance from the patient's experienced gender. However, of the 71 ACA plans, 69 outlined cosmetic exclusions, possibly nullifying this coverage. Limitations Data were sourced from publicly available online information in 2021. Additionally, we were unable to confirm explicit coverage of these procedures with insurance companies. Conclusion The majority of ACA silver and Medicaid plans did not cover gender-affirming neurotoxin or filler procedures, limiting access to this gender-affirming care.
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Affiliation(s)
- Karin Roszell
- Department of Dermatology, Michigan Medicine, Ann Arbor, Michigan
| | - Daniel Shumer
- Department of Pediatric Endocrinology, Michigan Medicine, Ann Arbor, Michigan
| | - Jeffrey Orringer
- Department of Dermatology, Michigan Medicine, Ann Arbor, Michigan
| | - Frank Wang
- Department of Dermatology, Michigan Medicine, Ann Arbor, Michigan
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4
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Grant-Kels JM. JAAD Game Changer: Medical and aesthetic procedural dermatology recommendations for transgender patients undergoing transition. J Am Acad Dermatol 2024; 90:676. [PMID: 37689162 DOI: 10.1016/j.jaad.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023]
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5
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Gu Y, Tang GT, Cheung ASZ, Sebaratnam DF. Dermatological considerations for transgender and gender diverse patients: An Australian perspective. Australas J Dermatol 2024; 65:24-36. [PMID: 37919972 DOI: 10.1111/ajd.14179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 11/04/2023]
Abstract
Transgender and gender diverse (TGD) individuals are a group that experiences significant health disparities. In the multidisciplinary management of TGD patients, dermatologists may participate in managing skin- and hair-related issues which contribute to gender affirmation and to the cutaneous sequelae of gender-affirming hormone therapy. This review aims to highlight the unique needs of TGD patients, particularly from the perspective of Australian dermatologists. We review appropriate terminology critical for TGD care, gender affirmation in the Australian healthcare landscape, dermatological considerations for TGD patients and considerations for management.
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Affiliation(s)
- Yaron Gu
- Faculty of Medicine and Health, The University of New South Wales, Kensington, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Gia Toan Tang
- Trans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
| | - Ada Sau-Zhuen Cheung
- Trans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
| | - Deshan Frank Sebaratnam
- Faculty of Medicine and Health, The University of New South Wales, Kensington, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Liverpool, New South Wales, Australia
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6
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Lagacé F, D’Aguanno K, Prosty C, Laverde-Saad A, Cattelan L, Ouchene L, Oliel S, Genest G, Doiron P, Richer V, Jfri A, O’Brien E, Lefrançois P, Powell M, Moreau L, Litvinov IV, Muntyanu A, Netchiporouk E. The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications. J Cutan Med Surg 2023; 27:NP1-NP36. [PMID: 37401812 PMCID: PMC10486181 DOI: 10.1177/12034754231177582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/29/2023] [Accepted: 04/09/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress. OBJECTIVES AND PROJECT DESCRIPTION The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth. FUTURE IMPACT With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | | | - Connor Prosty
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Alexandra Laverde-Saad
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Leila Cattelan
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Lydia Ouchene
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Sarah Oliel
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Genevieve Genest
- Division of Allergy and Immunology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Philip Doiron
- Division of Dermatology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Abdulhadi Jfri
- Department of Dermatology, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Elizabeth O’Brien
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Philippe Lefrançois
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Mathieu Powell
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Linda Moreau
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Ivan V. Litvinov
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Anastasiya Muntyanu
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Elena Netchiporouk
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
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7
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Viscomi B. From Anatomical Modifications to Skin Quality: Case Series of Botulinum Toxin and Facial Fillers for Facial Feminization in Transgender Women. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1333-1345. [PMID: 35860607 PMCID: PMC9293247 DOI: 10.2147/ccid.s363882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022]
Abstract
A transgender individual is someone who does not identify with his or her biological sex1. During the transgender transition process, minimally invasive procedures (MIP) provide a versatile tool in the clinician’s therapeutic armamentarium, since the changes can be impactful for the patient, yet reversible, especially for the patient who is unsure about proceeding with a definite surgery. We report 5 cases of facial feminization of transgender women, illustrating the use of minimally invasive facial remodeling procedures for male-to-female transitioning patients. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/ZFX5UTqnB2U
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Affiliation(s)
- Bianca Viscomi
- Dermatology, Private Practice, São Paulo, São Paulo, Brazil
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8
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Swink SM, Castelo-Soccio L. Dermatologic considerations for transgender and gender diverse youth. Pediatr Dermatol 2021; 38 Suppl 2:58-64. [PMID: 34250638 DOI: 10.1111/pde.14685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sexual and gender minority individuals, including transgender and gender diverse people, are an underserved and vulnerable population in the field of dermatology. While the unique dermatologic needs for adult patients in this group are increasingly documented, the knowledge surrounding pediatric and adolescent transgender/gender diverse patients is lacking. We aim to summarize the unique dermatologic needs of transgender/gender diverse patients, with particular attention paid to the data available in younger groups. This review highlights the unique role pediatric dermatologists can play in the care of transgender and gender diverse youth including but not limited to treating acne and hair pattern changes as well as being knowledgeable about surgical and other cosmetic options for gender affirmation. It also highlights areas for potential future research including dermatologic effects of hormone therapy in children as well as treatments for those side effects.
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Affiliation(s)
- Shane M Swink
- Division of Dermatology, Lehigh Valley Health Network, Allentown, PA, USA
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9
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Vengalil N, Shumer D, Wang F. Developing an LGBT curriculum and evaluating its impact on Dermatology Residents. Int J Dermatol 2021; 61:99-102. [PMID: 34416015 DOI: 10.1111/ijd.15842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/04/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Nathan Vengalil
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Shumer
- Department of Pediatric Endocrinology, University of Michigan, Ann Arbor, MI, USA
| | - Frank Wang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
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10
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Harris J, Premaratne ID, Spector JA. Facial Masculinization from Procedures to Payment: A Review. LGBT Health 2021; 8:444-453. [PMID: 34403627 DOI: 10.1089/lgbt.2020.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As the demand for gender-affirming procedures continues to increase, patients and providers have a greater imperative to understand the current state of facial masculinization. Facial reconstruction for transgender women has been shown to treat gender dysphoria effectively and reduce rates of discrimination and victimization. Although facial masculinization surgery for transgender men is less common, there are multiple surgical and nonsurgical options to supplement the effect of hormone therapy on facial appearance, including but not limited to: receding the hair line, flattening the forehead, expanding the supraorbital ridge, increasing the dorsal nasal projection, squaring the jaw, and augmenting the chin. This review aims to summarize these techniques for providers who wish to inform transgender male patients about their options and discuss them in the context of patient satisfaction and availability of insurance coverage.
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Affiliation(s)
- Jason Harris
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Ishani D Premaratne
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Jason A Spector
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA.,Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA
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11
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Pregnall AM, Churchwell AL, Ehrenfeld JM. A Call for LGBTQ Content in Graduate Medical Education Program Requirements. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:828-835. [PMID: 34031304 DOI: 10.1097/acm.0000000000003581] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A well-developed body of literature demonstrates that lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals experience poorer health outcomes and report worse health care experiences than straight/cisgender individuals. Many reforms since 2010 have addressed the LGBTQ-related education of future health care professionals at the undergraduate medical education (UME) level; however, reforms at the graduate medical education (GME) level are lagging, and new literature suggests that didactic education at the UME level is not enough to prepare future physicians to properly and compassionately care for LGBTQ patients. Recently, the Accreditation Council for Graduate Medical Education (ACGME) implemented a major revision of its Common Program Requirements that requires residents to demonstrate, as a competence, respect and responsiveness to diverse populations. Given these revisions and the ongoing failure of many GME training programs to adequately prepare future physicians to care for LGBTQ patients, the authors argue that now is the time for the ACGME to develop and implement LGBTQ health-related residency requirements. In addition, the authors outline a path by which the academic medical community may develop and implement these requirements.
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Affiliation(s)
- Andrew M Pregnall
- A.M. Pregnall is LGBTQ health intern, Vanderbilt Program for LGBTQ Health, Vanderbilt University Medical Center, Nashville, Tennessee; ORCID: https://orcid.org/0000-0001-9629-0636
| | - André L Churchwell
- A.L. Churchwell is professor of medicine (cardiology), professor of radiology and radiological sciences, professor of biomedical engineering, and senior associate dean, Diversity Affairs, Vanderbilt University School of Medicine, and chief diversity officer, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jesse M Ehrenfeld
- J.M. Ehrenfeld is senior associate dean and director, Advancing a Healthier Wisconsin Endowment, the Medical College of Wisconsin, Milwaukee, Wisconsin
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12
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De Boulle K, Furuyama N, Heydenrych I, Keaney T, Rivkin A, Wong V, Silberberg M. Considerations for the Use of Minimally Invasive Aesthetic Procedures for Facial Remodeling in Transgender Individuals. Clin Cosmet Investig Dermatol 2021; 14:513-525. [PMID: 34012284 PMCID: PMC8128506 DOI: 10.2147/ccid.s304032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022]
Abstract
There is increasing demand among transgender individuals for minimally invasive aesthetic procedures, such as injectable facial fillers and neurotoxins, for facial remodeling and transformation. These procedures may increase transgender individuals’ satisfaction with their appearance and allow them to more effectively harmonize their physical appearance with their perception of self. There is currently a lack of information in the medical literature regarding guidelines for the use of these products in transgender patients. In this report, the authors provide experience-based treatment considerations and recommendations for use of minimally invasive facial aesthetic procedures in transgender patients, including case studies illustrating the use of these procedures for both male-to-female and female-to-male transitioning patients. This report highlights the success of minimally invasive methods for assisting transgender patients in achieving their facial remodeling goals. Clinicians play an integral role in the transitioning process for transgender patients, and facial transformation is a key element of this process. When conducted with sensitivity and attention to individual patient goals at varying stages of transition, facial procedures can be of great benefit in enhancing patients’ self-perception and overall quality of life.
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Affiliation(s)
| | | | - Izolda Heydenrych
- Cape Town Cosmetic Dermatology Centre, Cape Town, South Africa.,Division of Dermatology, Faculty of Health Sciences, University of Stellenbosch, Stellenbosch, South Africa
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13
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Bonati LM, Petrell K, MacGregor J, Kandula P, Dover JS, Kaminer MS. The effects of neurotoxin and soft tissue fillers on gender perception in transgender individuals: A pilot prospective survey-based study. J Am Acad Dermatol 2021; 86:690-693. [PMID: 33684490 DOI: 10.1016/j.jaad.2021.02.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/22/2021] [Accepted: 02/27/2021] [Indexed: 10/22/2022]
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14
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Singer S, Yeung H, Mostaghimi A. State Medicaid Coverage of Dermatologic Procedures and Other Gender-Affirming Services for Transgender Patients in the United States. LGBT Health 2020; 7:166-168. [PMID: 32096701 DOI: 10.1089/lgbt.2019.0161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sean Singer
- Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Howa Yeung
- Department of Dermatology, School of Medicine, Emory University, Atlanta, Georgia
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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15
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Abstract
Sexual and gender minority (SGM) individuals include, but are not limited to, those who identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ). LGBTQ individuals are considered a marginalized and at-risk population, facing significant health care inequities when compared with heterosexual and cisgendered (ie, "gender-conforming") populations. They are more likely than heterosexual and cisgendered individuals to experience discrimination, bias, and dissatisfaction with the medical system. This article provides a broad overview of systemic inequalities confronting SGM patients.
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Affiliation(s)
- Erica Arnold
- Spring Street Dermatology, 73 Spring Street, Suite 303, New York, NY 10012, USA; University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Nikhil Dhingra
- Spring Street Dermatology, 73 Spring Street, Suite 303, New York, NY 10012, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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16
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Gender Affirmation Surgery: A Primer on Imaging Correlates for the Radiologist. AJR Am J Roentgenol 2019; 213:1194-1203. [PMID: 31414889 DOI: 10.2214/ajr.19.21686] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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17
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Historical and Current State of Dermatologic Care for Sexual and Gender Minority Populations. Dermatol Clin 2019; 38:177-183. [PMID: 32115126 DOI: 10.1016/j.det.2019.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The lesbian, gay, bisexual, transgender, and queer or questioning/sexual and gender minority (LGBTQ/SGM) community is a growing population with unique lifestyles, sexual practices, beliefs, health issues, and concerns. Although significant advances have been achieved in recent years to establish better care for LGBTQ/SGM patients, they still face insurmountable stigmatization and health care inequality. Dermatologists play an important role in LGBTQ/SGM patients' well-being because they not only treat their skin conditions, but also help them achieve desirable physical characteristics. This article discusses historical perspectives and current state of LGBTQ/SGM dermatology and attempts to define directions for future research and improvement.
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Fakhoury JW, Daveluy S. Incorporating Lesbian, Gay, Bisexual, and Transgender Training into a Residency Program. Dermatol Clin 2019; 38:285-292. [PMID: 32115139 DOI: 10.1016/j.det.2019.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) patients experience vast health care disparities. Numerous government and professional organizations have attempted to address these disparities by calling for improvement in LGBT health and increased research endeavors. Despite these initiatives, residents still receive inadequate education and training in LGBT health. Here, the authors review these shortcomings and provide a framework for how to improve resident education and training in LGBT health. They describe methods of curricular enhancements and departmental/institutional climate optimization to improve resident competency. Finally, they discuss how LGBT-competent physicians can publicize their expertise and improve overall LGBT health care delivery.
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Affiliation(s)
- Joseph W Fakhoury
- Department of Dermatology, Wayne State University School of Medicine, 18100 Oakwood Boulevard, Suite 300, Dearborn, MI 48214, USA
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, 18100 Oakwood Boulevard, Suite 300, Dearborn, MI 48214, USA.
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