AAD
Author: Willhemenia Loremipsum Special session: Lorem ipsum dolor sit amet Category: Lorem ipsum View all results

Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.

  • Presentation

Breast Issues in Transgender and Gender Diverse Patients

Description

In this presentation, Dr. Mange discusses breast-related health issues faced by transgender and gender diverse patients, particularly focusing on both trans masculine and trans feminine individuals. He begins with an overview of gender-affirming care, outlining how hormone therapies (feminizing and masculinizing) and surgical interventions, such as breast augmentation and top surgery, play a crucial role in aligning physical appearance with gender identity. For trans masculine individuals, chest appearance is a primary concern, often addressed through surgery or binding methods, which can lead to dermatological complications, including skin infections and acne. Dr. Mange emphasizes the importance of counseling these patients on safe binding practices and potential skin issues while being sensitive to their needs for gender expression. In contrast, trans feminine individuals often prioritize facial aesthetics but also pursue breast augmentation, which presents unique challenges due to anatomical differences. The risks of illicit filler injections and hair removal are highlighted, with a focus on the psychological benefits of effective hair removal services available through dermatology practices. Lastly, the presentation covers breast cancer screening guidelines, noting that screening protocols depend on the assigned sex at birth and the individual’s surgical history. Overall, Dr. Mange advocates for informed and compassionate care, addressing the specific needs and concerns of transgender patients.

View more

Conclusions

  • Gender-affirming care, including hormone therapy and surgeries, significantly impacts transgender and gender-diverse individuals' health and well-being.
  • Trans masculine individuals prioritize chest appearance, leading to increased reliance on binding methods to achieve a masculine chest, which can cause dermatological complications.
  • Chest binders can lead to skin infections and other health issues, emphasizing the need for proper counseling on their use.
  • Surgical options for transmasculine individuals, such as double incision or keyhole mastectomy, vary based on breast size and body type.
  • Trans feminine individuals face unique challenges in breast augmentation due to anatomical differences, requiring specialized surgical approaches.
  • Illicit use of silicone for breast augmentation poses serious health risks, including infections and migration of the substance.
  • Hair removal is a major concern for transfeminine patients and is correlated with decreased psychological distress and improved quality of life.
  • Insurance coverage for gender-affirming procedures, including hair removal, is often limited, highlighting a need for improved policies.
  • Breast cancer screening for transgender individuals should be tailored based on their hormone treatment history and surgical status, mirroring guidelines for cisgender individuals.
  • Ginsberg BA, Calderon M, Seminara NM, Day D. A potential role for the dermatologist in the physical transformation of transgender people: A survey of attitudes and practices within the transgender community. J.Am Acad Dermatol. 2016;74(2):303-308.
  • Peitzmeier SM, Silberholz J, Gardner TH, Weinand J, Acevedo K. Time to first onset of chest binding-related symptoms in transgender youth. Pediatrics. 2021;147(3):e20200728.
  • Sergi FD, Wilson EC. Filler use among trans women: correlates of feminizing subcutaneous injections and their health consequences. Transgend Health. 2021;6(2):82-90.
  • Bertin C, Abbas R, Andrieu V, et al. Illicit massive silicone injections always induce chronic and definitive silicone blood diffusion with dermatologic complications. Medicine (Baltimore). 2019;98(4):e14143.
  • Coleman E, Radix AE, Bouman WP, et al. Standards of care for the health of transgender and gender diverse people, version 8. Int J Transgend Health. 2022;23(Suppl 1):S1-S259.
  • Sonnenblick EB, Chaudhry S, Lee KA, et al. MRI features of free liquid silicone in the transgender female breast. Journal of Breast Imaging. 2021;3(3):322-331.