Ethics in Aesthetics: Navigating through the gender minefield

The NHS defines gender dysphoria as a condition where a person experiences discomfort or distress because there is a mismatch between their biological sex and their gender identity. According to the NHS clinic for gender non-conforming children and young people in the UK, referrals have risen from 77 people during 2009–2010 to 2590 people during 2018–2019 (Tavistock and Portman NHS Foundation Trust, 2019). There continue to be mixed views and opinions towards this rise in people who express gender fluidity or identify as transgender; Camille Paglia, a professor at the University of Arts in Philadelphia, said in a public interview that ‘The transgender definition has become a convenient label for young people who may simply feel alienated culturally for other reasons’ (Miltimore, 2017). However, the American Psychological Assocation states that ‘Transgender persons have been documented in many indigenous, Western, and Eastern cultures and societies from antiquity until the present day’ (2014). Whether agreeing with the latter statement or perhaps feeling that we have cultivated a society with a greater awareness of gender identity issues, there is still a gap in our mentality and this affects our ability to comfortably and sensitively treat transgender patients. One survey discovered that two in five trans people (which equates to 41% of the 871 trans people asked) felt that healthcare providers lacked knowledge and understanding of trans healthcare needs, while this percentage increases to 51% for trans people living in Wales (Stonewall, 2018). Furthermore, 7% advised they had been refused care within the last year (Stonewall, 2018). Many physicians have confirmed that it is through a lack of familiarity with transition care guidelines and knowledge that poses a problem when faced with treating a transgender patient. If transgender care is not yet adequately taught in medical schools, this raises the question of how a similar lack of familiarity when treating trans people in an aesthetic environment can be avoided.