A Genderfluid Approach to Aesthetic Language in Dermatology

January 2022 | Volume 21 | Issue 1 | 96 | Copyright © January 2022


Published online December 27, 2021

Marc M. Beuttler MDa, Jennifer MacGregor MDb

aLouisiana State University Health Sciences Center, New Orleans, LA
bUnionDerm, New York, NY

Abstract
Dermatologists are in a unique position to help transgender and non-binary individuals achieve an appearance that corresponds to their identity. Minimally invasive procedures for gender affirmation are relatively safe and customizable, providing an increasingly favorable treatment niche for these patients.1-4

INTRODUCTION

Dermatologists are in a unique position to help transgender and non-binary individuals achieve an appearance that corresponds to their identity. Minimally invasive procedures for gender affirmation are relatively safe and customizable, providing an increasingly favorable treatment niche for these patients.1-4 However, many physicians employ gendered language such as “masculine” or “feminine” to describe aesthetic features or traditional ideals of beauty that might not correspond to the way many transgender, nonbinary, and even cisgender patients see themselves or wish to be seen. Describing appearances as more ‘feminine’ or ‘masculine’ is a subjective generalization that can cause psychological upset or frank offense for a patient with a nonbinary gender identity or gender dysphoria.5 We believe that this gendered language should be avoided or minimized in most clinical interactions with patients, in the media, and in marketing. We urge dermatologists to adopt gender-neutral aesthetic language that describes the individuals’ specific goals and features rather than relying on historically gendered beauty ideals.

Dermatology’s Status Quo
Dermatology has fallen behind many industries in recognizing human gender fluidity. Many fashion models and actors are scouted and celebrated for their unique and different aesthetic presentation. We routinely see fashion campaigns that blur gender lines and celebrate striking androgynous features as something to be desired (Figures 1, 2, and 3).

Dermatologists, as increasingly important healthcare providers to transgender and gender nonbinary individuals, are in a position to modernize the way physicians conceive of gender and to improve the experience of gender-diverse patients.2 There is ample evidence that minimally invasive aesthetic procedures can improve the psychological well-being of cisgender patients.8,9 Limited data from a recent pilot study demonstrates that transgender individuals also gain quality of life improvement following aesthetic injectable enhancements, even if the cosmetic change is subtle and the patient's perceived gender is unchanged.10 People routinely report that small and subtle enhancements, often termed “tweaks” or “tweakments” have a profound impact on their mood, confidence, and general outlook.11 Unlike surgical interventions, outpatient treatments such as lasers, tightening modalities, injectable fillers, threads, and neurotoxins do not require pretreatment psychologica


l