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A Body-Neutral and Gender-Neutral Modified Ferriman-Gallwey Diagram
Frances Grimstad1, Quentin Moyer2, Coleen R Williams3
1Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts.
Background:
The modified Ferriman-Gallwey (mFG) diagram for scoring hirsutism uses images with traditionally Eurocentric feminine features. No reports have documented its utility in patients with other gender identities.
Case:
A 16-year-old nonbinary masculine patient, assigned female sex at birth, was seen for hyperandrogenism and irregular menses. They declined an exam, citing body dysphoria, and declined self-documenting on the mFG diagram, expressing anxiety with gendered images. We subsequently developed a novel, gender-inclusive mFG diagram, which the patient was then comfortable using to document their hair pattern.
Summary And Conclusion:
This case documents how the binary gendered characteristics of the mFG diagram can impact the care of patients. As gender expression is highly individual, we created the first gender-inclusive version of the mFG diagram to enhance care for all patients.
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