The Use of Non-Surgical Injectable Procedures Among Transgender Communities

Abstract

Each year, millions of Americans undergo non-surgical injectable procedures to rejuvenate, add volume, and shape the face. These minimally invasive procedures are routinely performed by licensed medical professionals including plastic surgeons and dermatologist using FDA approved substances. Because these procedures alter physical appearance, non-surgical injectable procedures may compliment gender-affirming procedures that some transgender (trans) individuals undergo to affirm their gender identity. However, severe marginalization and discrimination towards trans communities often leaves formalized medical settings inaccessible. Indeed, anecdotal reporting and medical literature indicate that there is a market for performing these procedures in unregulated medical settings using dangerous non-FDA approved materials outside of safe medical settings. The practice, referred to often as “pumping”, happens particularly within trans communities, largely because of social and political factors that make formalized medicine inaccessible. Even though pumping can be an affirming experience for trans individuals, an unfortunate number of those who undergo non-FDA approved non-surgical injectable procedures experience uncorrectable adverse outcomes including death. Despite indications that trans individuals may benefit from FDA approved non-surgical injectable procedures and the growing literature detailing irreversible outcomes of non-FDA approved non-surgical injectable procedures, the medical and scientific communities do not fully understand how trans individuals conceptualize and engage with non-surgical injectable procedures. A brief overview of factors that may contribute to this underground practice is presented in this narrative review and synthesized to inform suggestions for future socio-behavioral and epidemiological approaches that ultimately aim to expand access to safe and affirming healthcare settings for trans individuals.