ABSTRACT
Objective: Gender nonconformity refers to individuals whose gender identity, roles, or expressions do not adhere to societal standards and norms. Affirmative care is an approach to healthcare delivery in which organizations, programs, and providers recognize, validate, and support the identity stated or expressed by the individuals served. This study examined the effects of nonsurgical interventions performed by dermatologists, specifically botulinum toxins (BoNTA) and dermal filler injections, on the physical and mental health of Filipino gender nonconforming individuals. Methods: Six gender nonconforming patients received filler and BoNTA injections to enhance their desired facial features. The patients were interviewed before and three months after the treatment session. Baseline and three months posttreatment photos were used to examine treatment results, including the facial width-to-height ratio (FWHR). Three months after treatment, the patients answered a five-question Likert-scale satisfaction survey. Results: Patients reported high satisfaction with the treatment outcomes (median=5) and agreed that the treatment met their expectations (median=5). They reported improved fine lines and wrinkles (median=5) and increased self-confidence (median=5). All participants strongly recommended the treatment to others (median=5). Changes in FWHR varied among participants who requested a feminine appearance, except for one participant who sought a masculine appearance and whose FWHR increased. Conclusion: Sensitivity, openness, and knowledge regarding the facial aspirations and treatment preferences of gender nonconforming patients can improve outcomes and increase patient satisfaction in this patient population.
ABSTRACT
BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Multiple risk factors are associated in the development of BCC, with ultraviolet light and genetics playing major roles. AIMS: The departments of dermatology, medical oncology, ophthalmology, otorhinolaryngology, head and neck surgery, plastic surgery, and radiation oncology of the Jose R. Reyes Memorial Medical Center, Manila, Philippines, have convened and formulated consensus statements on the diagnosis and management of BCC patients seen in the institution. CONCLUSION: The summary of the recommendations is: (1) Surgery is the treatment of choice for BCC. The range of margins (2-4 mm) depends on the type of BCC. (2) Mohs micrographic surgery (MMS) is indicated for high risk BCC. (3) Topical treatment with imiquimod or 5-flourouracil (5-FU) may be used for superficial BCC. (4) Destructive methods (cryotherapy, curettage and electrodessication, photodynamic therapy) may be used for low risk BCC. (5) Medical and/or radiation therapy is advised for cases where surgery is contraindicated or tumor is not amenable to surgery. Metastasis of this malignancy is rare. Follow-up, which may continue up until 2 years, is recommended for high risk BCC.
