Unforeseen ethical challenges for isotretinoin treatment in transgender patients

Prescribing Isotretinoin for Transgender Patients: A Call to Action and Recommendations

“…7 These issues have been raised in the past, with several articles from 2016 to 2019 urging for gender-neutral registration. [10][11][12][13] A gender neutral patient categorization model of iPLEDGE is also supported by both the American Medical Association (AMA) and American Academy of Dermatology (AAD). 14,15 However, despite the pleas from clinicians and patients, no change has yet been made to iPLEDGE.…”

Transgender adolescents and acne: A cases series

“…In patients with natal female internal genitalia, it should be remembered that isotretinoin is teratogenic, and patients need to be warned that pregnancy should be avoided; such patients may find themselves in testosterone‐associated amenorrhea and may therefore believe they cannot become pregnant . The risk of gestation in female‐to‐male transgender individuals undergoing testosterone treatment is difficult to quantify, but it is real.…”

A cross-sectional survey of knowledge, attitudes, and practice in the prescription of isotretinoin for transgender patients among academic dermatologists

“…1,2 The US Government Accountability Office has estimated that almost half of these increases have affected dermatologic drugs. 3 Decreased competition and supply shortages have been suggested as reasons for fluctuation, but little is known about whether the frequency of price increases is changing over time. 4 To evaluate trends in dramatic price increases of more than 100% for topical medications, we performed cross-sectional and longitudinal analysis of National Average Drug Acquisition Cost data from the Medicaid Pharmacy Pricing database from January 1, 2014, through December 19, 2018.…”

“…To the Editor: Multiple reports have called attention to the complexity of assigning transgender patients to a category within the iPLEDGE system, [1][2][3] especially transgender men ( female to male) receiving testosterone therapy who retain their reproductive organs and have the potential to become pregnant. 4 Prescribers must choose between enrolling transgender patients under the sex assigned at birth (which is discordant with the gender identity) or the gender they align with (which is noncompliant with iPLEDGE).…”