Top and bottom surgery are perhaps the most high-profile gender-affirming treatment options available to the trans community, but from filler to facial treatments, there are a host of less-invasive procedures that can help individuals become their most authentic selves. For those transitioning, hormonal changes caused by an increased intake of testosterone or estrogen can have a noticeable impact on skin conditions like acne, sebum production, and facial hair, while those who have received a double mastectomy will often seek treatments to reduce the appearance of post-surgery scars.
However, not all treatment providers—such as plastic surgery offices—are catering to this community. From inclusive language to optimized treatments, several establishments are putting in the necessary education, infrastructure, and treatment options to provide a welcoming space. With the likes of Ever/Body placing a new emphasis on trans inclusivity for their training programs and aesthetics treatments, there are positive changes in place—but still plenty more ways to go.
Establishing New Service Providers
Leola Davis, founder of Pansy Esthetics, was inspired to create a business catering to BIPOC and LGBTQI+ communities in response to personal experiences of exclusion, not just in her own life, but those in her inner circle. “I myself, as a queer Black woman, who falls outside of the mainstream norm of ‘beauty,’ faced a lot of adversity when I was seeking aesthetic care and also trying to work within the field. I started speaking to my trans friends and realized that most, if not all, were uncomfortable or afraid to seek out services or had already experienced less-than-ideal care from providers. I was working in a toxic work environment at a medical spa that was draining me, so I quit and started Pansy a week later to better serve myself and my community,” she explains. Today, she offers post-op treatments, skin/scar revision, and facial treatments from her LA-based studio.
Increasing customization opportunities enabled through AI technology and more flexible treatment plans are also helping to lead the way. LGBTQ+-founded and AI-focused skincare solutions platform Coralai, launched by Corpus Group Inc., incorporates the needs of all clients across the gender spectrum, thanks to personalized skin diagnostic reports and curated product recommendations enabled through computer vision technology-captured facial imaging.
“As a company we’ve adopted the practice of listening to our community and building our technology based on feedback from providers, clients, and shoppers in the broader skincare market,” comments Coralai CEO Sean Patrick Harrington, whose previous tenures include being the founder of Previse SkinCare, Senior Marketing Director at L'Oréal, and Senior Brand Development Manager at Unilever. “In conversations with our network of skincare professionals and transgender communities, we discovered the incredibly limited resources available to those going through the transitioning process. The physical, emotional, and mental stress created during the search to find adequate support is significant. Coralai’s proprietary memory allows people to document and track changes in their skin over time, while comfortably and safely connecting with professionals who can guide them through their transition, which is incredibly important.”
The platform’s projected professional network reach is set to hit 500,000 by 2024. One such professional is Chandra Bredel, an aesthetician and aesthetics educator who offers FTM (female to male) and MTF (male to female) transgender skin acclimation treatments. These include in-office skin and body care procedures that treat hormonal skin concerns, as well as top and bottom post-surgical scar softening, pigment correction, and permanent cosmetic enhancements like lip blush and 3D areola design. Her most requested service is scar revision for post-op, which can be a combination of multiple procedures like nano-needling, cosmetic tattooing, and appropriate at-home skin treatments like pigment corrector serums and barrier restoration creams.
“As one of the first aestheticians to help those seeking transition over 20 years ago, the main concern my clients have expressed to me was the need to find a safe space to be their true self, to express their feelings even before they decide if surgery is the answer for their unique situation,” she explains. “It is never a one-size-fits-all [solution] for any client that sees me—being able to fully understand the wound-healing process, designing the right sequence of treatments, recommending the correct home care regimen both pre-surgery and post-surgery, and of course the emotional support necessary for all experiencing a need for corrective skincare.”
Aesthetics treatments need to cater to a variety of procedure outcomes, from masculinized to high femme. Here BeautyFix MedSpa, which offers services like facial feminization via injectables and laser hair removal, puts an emphasis on diversifying the styles and skills of its service providers. “In terms of an actual skill set, it's a huge challenge that requires retraining. Unless you have pharmaceutical or plastic surgery-focused companies go in and retrain [service providers], it’s unlikely that you'll see many people entering this market,” CEO Maya Benayoun remarks. “That’s why it's important to have multiple injectors or surgeons with differing skill sets: one that likes to do things a little bit more naturally, one that does things for a little bit more of an extreme look. When people call to make an appointment, we match them with the right provider to make sure they get that result.”
Ensuring representation in its training, as well as workforce, the company counts nightlife legend and trans icon Amanda Lepore as a regular client and social media collaborator. “Unless you consciously both hire people that are part of the community and have them teach by example, or unless you specifically train on pronouns, which we do, it is unlikely that your staff will know what to do when somebody who is of a different gender identity walks into the clinic,” Benayoun adds. “We have a rainbow of employees, and the reason we do that is because we welcome clientele of all ages, backgrounds, and gender identities.”
Moving Beyond the Binaries
As gender binaries and identities continue to evolve, so should the offerings of service providers. “It's really important that providers stop gendering their services and start to think about skincare and body care in general outside of the gender binary. We as providers have to stop assuming gender and invest in the well-being of our clients inside and outside of the treatment,” says Davis, who also offers classes on how to make the aesthetician treatment room more accessible, as well as queer- and trans-friendly.
Joseph Harwood, a gender-nonconforming beauty expert and artist who has been pushing for more diverse gender representation in the beauty industry since 2007, echoes this sentiment. They recently partnered with Coralai to offer virtual skincare consultations, consulted on L'Oréal’s genderless makeup brand Jecca Blac, and recently collaborated with MAC Cosmetics on a limited-edition product edit.
“Trans means, I don’t feel liberated being forced into this identity structure, so here’s more about me. This is the side of the conversation that has been completely and utterly lost in translation because the media have focused entirely on sex-based laws, which have a necessity in our culture when there are crimes happening based on your perceived gender, but it’s a balance of the two,” they explain.
As a child model who later segued into television work, Harwood was confronted with the “closed-off categories” indicative of a society wanting to pigeonhole individual identities. “I have been told by agencies in the UK as early as 2015 that I would have to have a masculine alter ego to be signed with them, and it’s just total stupidity. What these businesses want to do is simplify someone down to such a shallow category that they can barter with them, so here’s the drag queens, here is a person of color. Let’s tick these boxes and look diverse, but it’s the opposite of diversity or inclusivity,” they remark. “Being an individual throws a spanner in the works for how they run their business, and it limits the potential that you can reach. I find that now that I'm over 15 years in, I have a lot more authority in what I do, so I am quite happy to speak directly to people who make the decisions. But there is a lot of gatekeeping, which is exhausting.”
Authentic Leadership and Representation
One tool in reducing that gatekeeping is growing representation of gender-nonconforming individuals in the C-suite. Harwood, who is currently working on a database with the British Beauty Council that spotlights gender-diverse thought leaders in the beauty industry, is noticing an increase, but with a caveat. “I want people to be able to earn their way into a position of leadership. I don’t want to see people tokenized, and I think that’s the next step. We need to identify who has been setting trends, who has held value, who has inspired beauty moments, and why they are not at the forefront of the industry,” they state. “I often work with brands and they want to do a Pride campaign and don’t pay the same rate. They have cis people who they consider to be key influencers because they’ve been working online for 10 years, but where are the key LGBT influencers with the same impact? You’re not even considered in the lineup outside of Trans Day of Visibility. That needs to change.”
Finding more nuance in these conversations is equally important. As Harwood explains: “Respecting people's language preferences and having an insight into the fact that many people who identify as transgender are biologically or chemically intersex, but have not had any kind of medical intervention, is something that is completely omitted to most discussions around this topic. For me, there are a lot of points of reference and information about individual accounts of medical transition, but there is a gap in the knowledge around people who have chemical intersexuality or extra chromosomes.” Intersexuality is as common as one in every 5,000 people.
Black-and-white perspectives omit the beauty of the many shades of gray. Similarly, providing treatments and aesthetic services for all gender identities means addressing all the details that go into an all-embracing atmosphere. Enterprises like Pansy Esthetics, Coralai, and BeautyFix MedSpa have planted the seeds for change—now they just need to be nurtured to flourish and multiply.
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