Dermatologic care of the lesbian, gay, bisexual and transgender community of India

Background: In the Indian subcontinent, the lesbian, gay, bisexual, transgender, and queer community, commonly referred to as the third gender or transgender, is expected to exceed one million by 2030. Data on dermatologic conditions of the transgender population is deficient.Aims: This study aimed to identify the common dermatological concerns and dermatologic procedures of the lesbian, gay, bisexual, transgender, and queer community of India.Methods: This cross-sectional survey analysed the transgender participants of a non-institutionalised population in India via health camps that included 51 adult participants who self-identified as trans men and trans women.Results: This study included 51 participants aged 20-49 years, of which the majority (94%) were trans women. The common dermatological problems were terminal hairs over the face, beard distribution, androgenetic alopecia, scars of gender-affirming surgeries, facial melanosis with topical steroid damaged skin and the need for facial feminisation procedures among trans women, while trans men had testosterone-related acne, androgenetic alopecia. Overall, 40.6% of participants reported dissatisfaction with one or more of their body parts. Laser hair removal was the most common gender-affirming dermatologic procedure.Conclusion: This study provides an essential overview of the common dermatological conditions and procedures in the Indian lesbian, gay, bisexual, transgender, and queer community. Lesbian, gay, bisexual, transgender, and queer persons have insufficient access to dermatological services due to inadequate exposure and fear of discrimination. Even though transgender patients also present with similar dermatologic conditions as the general population, they have distinct cosmetic and treatment concerns during the period of transition owing to hormone-related or surgery-related changes. Addressing these challenges through enhancing dermatology residency training programs should be the focus of tomorrow. Limitations: Considering convenience sampling and representative bias, further studies need to be conducted involving multiple study locations and larger sample sizes.