Study: Transgender Individuals Experience Stigma, Treatment Barriers

New research sheds light on the lived experiences of transgender individuals who have acne. 

"While acne is common in transgender and gender-diverse people and is associated with gender-affirming hormone therapy, little research has examined these factors and their impact in gender minority groups," the authors wrote.

Using mixed methods, the researchers followed 32 transgender and gender-diverse individuals with acne (17 transgender men, 11 transgender women, and 4 nonbinary participants). The methods included interviews, coding using minority stress theory and the socioecological model, and analyzation using thematic analysis. The themes, according to the study, were triangulated with survey data on gender, self-reported acne severity, skin-specific quality-of-life impact, and treatment experience. Ten participants reported their skin as currently clear/almost clear, 11 reported mild acne, and 11 reported moderate to severe acne.

According to the study, participants described their experiences of rejection and bullying related to their acne, and reported avoiding social interactions where they feared acne-related discrimination, leading to feelings of depression and anxiety. Transgender women in the study said that acne interfered with expressions of their femininity, and transgender males reported normalizing acne. Reported barriers to acne treatment included costs, mistrust of the health care system, lack of transgender-specific acne care education. Most participants reported having tried over-the-counter medications and commonly sought acne advice from physicians, online forums, and social media.

"Multilevel changes, such as developing strategies to reduce acne stigma, providing transgender-specific acne care education, facilitating multidisciplinary acne care, and expanding transgender-friendly clinical environments, are recommended to reduce the impact of acne in transgender individuals," the authors wrote. 

The study is published in JAMA Dermatology.