Sun Nora Yanyi, Kamal Kanika, Keuroghlian Alex Sogomon
Harvard College, Harvard University, 373 Quincy Mail Center 58 Plympton St, Cambridge, MA, 02138, United States, 1 904-646-8255.
Harvard Medical School, Cambridge, MA, United States.
JMIR Dermatol. 2025 Jun 6;8:e62714. doi: 10.2196/62714.
Scarring has been shown to have adverse health effects on marginalized patient groups. However, experiences of scarring among transgender and gender diverse (TGD) people have not yet been thoroughly characterized. .
This study aimed to investigate the impacts of scarring related to gender-affirming care and other causes among TGD people.
Anonymous data were extracted from Reddit, a popular online platform organized into "subreddit" groups based on identities and interests. A combined total of 604 posts and comments that explicitly reference physical scarring were extracted from r/FtM, a subreddit for transmasculine people (449 posts and comments) and r/MtF, a subreddit for transfeminine people (155 posts and comments). Applying inductive thematic analysis, all posts and comments were coded and codes were sorted into overarching themes. .
Among the 604 posts and comments, the scars most discussed were secondary to gender-affirming care procedures, including mastectomy (n=338 posts and comments), hormone administration (n=102 posts and comments), and hair removal (n=38 posts and comments). Nongender-affirming care-related scars, such as those due to self-harm (n=43 posts and comments), were discussed less often. A total of five overarching themes emerged through thematic analysis: (1) concerns about physical outcomes related to scarring; (2) psychological distress related to scarring; (3) societal perceptions of scarring; (4) strategies to prevent, conceal, and minimize scarring; and (5) positive experiences with scarring.
For TGD people, scar complications, visibility, and permanence represent major concerns. While many TGD people ultimately accept scarring as an unavoidable consequence, scarring both related and unrelated to gender-affirming care can present a significant psychosocial stressor for TGD people. Scarring can result in physical health complications, gender dysphoria, and negative body image; visible scarring is also a barrier for TGD people who wish to blend into society. Clinicians should improve communication regarding scarring outcomes and scar-care procedures. Future research should focus on the development of scar prevention, care, and reduction techniques for TGD people.
瘢痕已被证明会对边缘化患者群体产生不良健康影响。然而，跨性别者和性别多样化（TGD）人群的瘢痕经历尚未得到充分描述。
本研究旨在调查TGD人群中与性别肯定治疗及其他原因相关的瘢痕影响。
从Reddit提取匿名数据，Reddit是一个受欢迎的在线平台，根据身份和兴趣组织成“子版块”群组。从r/FtM（一个针对男性化跨性别者的子版块，有449篇帖子和评论）和r/MtF（一个针对女性化跨性别者的子版块，有155篇帖子和评论）中总共提取了604条明确提及身体瘢痕的帖子和评论。应用归纳主题分析，对所有帖子和评论进行编码，并将代码分类为总体主题。
在604条帖子和评论中，讨论最多的瘢痕继发于性别肯定治疗程序，包括乳房切除术（338篇帖子和评论）、激素给药（102篇帖子和评论）和脱毛（38篇帖子和评论）。与性别肯定治疗无关的瘢痕，如自残导致的瘢痕（43篇帖子和评论），讨论较少。通过主题分析共出现了五个总体主题：（1）对与瘢痕相关的身体结果的担忧；（2）与瘢痕相关的心理困扰；（3）社会对瘢痕的看法；（4）预防、遮盖和最小化瘢痕的策略；（5）瘢痕带来的积极体验。
对于TGD人群来说，瘢痕并发症、可见性和永久性是主要关注点。虽然许多TGD人群最终将瘢痕视为不可避免的后果，但与性别肯定治疗相关和无关的瘢痕都可能给TGD人群带来重大的心理社会压力源。瘢痕会导致身体健康并发症、性别焦虑和负面身体形象；可见瘢痕也是希望融入社会的TGD人群的障碍。临床医生应改善关于瘢痕结果和瘢痕护理程序的沟通。未来的研究应专注于为TGD人群开发瘢痕预防、护理和减少技术。
