How To Bring Your Ally A-Game To Gender-Affirming Care

Aesthetics providers have the tools to help our transgender and non-conforming (TGNC) clients close the gap between inner experience and outward expression. With trans and non-binary clients increasingly embracing reversible or temporary aesthetic treatments before—or in lieu of—surgical interventions, it’s important to understand how you can tailor your experience to support these clients. We asked Laura Lewman (ND, Portland, OR), Lilly Silva (MSN, ARNP, FNP-C, Bellevue, WA), and Vinny Sathe (BSN, RN, Greenwood Village, CO), to share their advice on creating inclusive experiences, and learned that it starts with adopting an ally mindset.

“My goal is to help people show up as their most authentic and confident selves,” Laura said. “It's all about creating a treatment plan that results in you feeling more like you!”

Make a Great First Impression

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Laura Lewman, ND and Client Care Coordinator/ her patient Eli[/caption]

No matter how talented you may be with a laser or a syringe, the treatment itself is one of the client’s last experiences in your office. As a provider, it’s important to review the client journey from start to finish to make sure that you’re meeting the client’s needs each step of the way.

“Gender non-conforming and trans persons want to be seen and treated as the gender identities they identify with,” Vinny said. “Showing my interest in their identity goes a long way in building a trusting relationship.”

Begin by making a practice of asking all patients, regardless of presentation, what their name and pronouns are, and modeling this behavior by introducing yourself using your name and pronouns. Review your intake forms, which should include questions about preferred names and pronouns. Staffers, in turn, should use those responses to shape client interactions.

If your office offers scheduling by phone, text or email, remind your staff that they should never presume to know a client’s gender identity. While it may be polite to refer to a client as, “Ms. X” or “ma’am,” it’s more inclusive to simply use the client’s first name when confirming details. “Thanks for calling, Jessie. We’ll see you next Tuesday.”

(And remember, if someone makes a mistake and misgenders a client, simply apologize and move forward.)

“I recognize that my clients are in different stages of their lives, identity, and gender transition,” Laura said. “I follow my client's lead and guidance about their pronouns, chosen name, and meet them where they're at.”

Popular Treatments for Trans and Non-Binary Clients

Temporary aesthetic treatments can be an important part of the gender journey, giving our TGNC clients the chance to “try on” a look and decide if it feels right.

“Most frequently, trans patients are looking to augment their physical characteristics to match the gender they identify as,” Vinny added. “Dermal fillers are safe and effective non-surgical treatment options that can assist these patients in achieving their desired outcomes.”

Lilly notes that the advantages of these non-surgical treatments are that they’re significantly cheaper than cosmetic surgery, temporary or reversible, and require little to no downtime.

“Trans feminine folx may desire to soften their facial features, which we can achieve with a combination of dermal fillers and neuromodulators. We may also discuss permanent hair removal solutions, such as laser hair removal,” Laura said. For those who want to appear more masculine, “building up the jawline and chin with dermal fillers can create a stronger, more angular look.“

Common Concerns

“When working with the trans community in the clinical setting, it is important to consider each patient’s personal experience with healthcare providers,” Vinny said. “Though awareness and sensitivity towards the trans community and their unique needs have improved, many trans persons may harbor negative feelings or lack trust towards healthcare systems and providers.”

Also keep in mind that clients who are receiving hormone therapies may have additional skincare concerns.

“Folx undergoing hormone replacement therapy may experience more acne breakouts and subsequent scarring that we may treat with medical grade skincare, microneedling, or light-based treatments,” Laura said.

Another concern is that financial barriers could pose obstacles to gender-affirming aesthetic treatments. A 2021 study found TGNC employees make 32% less than cis-gendered employees for the same work—even when TGNC individuals have similar or higher education levels. Plus, TGNC patients often have higher overall healthcare costs because many gender-affirming treatments are considered elective care.

One way to reach TGNC clients—or any prospective clients— who may not otherwise be able to afford your services is to offer an income-based sliding scale pricing model. Implementing equitable policies within your practice is one of the most significant steps you can take as an ally.

Why Gender-Affirming Care Matters


Gender-affirming care has the power to significantly improve the mental health and overall well-being of gender diverse, transgender, and nonbinary people. When done right, it can save lives. For patients who are not candidates for surgical intervention or who want to take their post-operative results further, non-surgical aesthetic treatments can be used to feminize, masculinize or androgynize features. Helping clients match their outward appearance to their inner mindset can provide peace of mind when navigating a complex emotional journey.

“A lot of my clients struggle with gender dysphoria, and I aim to help create facial characteristics to affirm gender identity and alleviate gender dysphoria as a result,” Lilly said. “In my practice, I want my clients to be able to look in the mirror and see a reflection that represents how they feel on the inside.”

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