Dermatologic disorders in transgender patients: A retrospective cohort of 442 patients

Abstract

To the Editor: Although the number of patients identifying as transgender has increased in recent decades, 1 Zucker K.J. Epidemiology of gender dysphoria and transgender identity. Sex Health. 2017; 14: 404-411 Crossref PubMed Scopus (146) Google Scholar there remains a practice gap regarding optimal dermatologic care for transgender patients. 2 Ginsberg B.A. Dermatologic care of the transgender patient. Int J Womens Dermatol. 2016; 3: 65-67 Crossref PubMed Scopus (32) Google Scholar , 3 Almazan T. Kabigting F. Dermatologic care of the transgender patient: highlighting a practice gap within dermatology. J Am Acad Dermatol. 2016; 74: AB29 Abstract Full Text Full Text PDF Google Scholar , 4 Marks D. Awosika O. Rengifo-Pardo M. Ehrlich A. Dermatologic considerations in transgender care. J Am Acad Dermatol. 2018; 79: AB102 Abstract Full Text Full Text PDF Google Scholar A retrospective chart review of all transgender patients evaluated at the Mayo Clinic in Rochester, Minnesota, from March 15, 1986, through June 21, 2018, was performed using billing codes for gender dysphoria, gender identity disorder, and transsexualism to identify patients of all ages for potential inclusion. Medical records were reviewed to ensure patients selected for inclusion met gender dysphoria diagnostic criteria based on current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria. When the threshold for inclusion was unclear, specific patients were reviewed by endocrinology providers. Patients with disorders of sexual development and those assigned intersex at birth were excluded. Statistical analysis was performed using the JMP Pro statistical software package, version 13.0 (SAS Institute Inc, Cary, NC). Comparisons were evaluated using Fisher's exact test. All P values less than .05 were considered statistically significant. Limitations include retrospective design, varied follow-up, selection via International Classification of Diseases, Ninth Revision code, and lack of generalizability.