Transgender Individuals' Perspectives on Teledermatology-Based Acne Research

This study aimed to identify barriers and facilitators influencing transgender individuals' participation in teledermatology-based acne research and their perceptions of artificial intelligence use in acne research.

This was a qualitative study conducted between 2021 and 2023. Transgender and gender diverse individuals who received gender-affirming hormone therapy and had acne were recruited from a public safety-net hospital and from academic endocrinology and dermatology clinics. Semi-structured interviews exploring factors influencing teledermatology-based acne research participation were analyzed using thematic analysis.

Among 32 participants, 17 (53%) identified as transgender men, 11 (34%) as transgender women, and 4 (13%) as non-binary or other gender identities. Mild or lower acne severity was reported by 21 (66%) participants, while 11 (34%) reported moderate-to-severe acne. Access to equipment and comfort in photographing sensitive areas determined capability of participation in hypothetical teledermatology research. Accessibility, flexibility, and reduced transportation cost of remote research, and in-clinic recruitment from established clinicians presented opportunities for participation. Motivating factors included trust in research team members, privacy concerns, and improving acne treatment for transgender individuals. Perspectives on artificial intelligence were mixed and included concerns regarding security and potential for bias.

Teledermatology offers opportunity to improve recruitment and retention of transgender individuals in acne research. Incorporating perspectives of transgender individuals can inform the design of future teledermatology research on acne in the context of gender-affirming hormone therapy.