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Skin through the transition journey

At E45, we believe that every person deserves to feel comfortable in their skin.

We know from research that many in the transgender, non-binary, and gender diverse community struggle with this, with 92% of trans+ people feeling uncomfortable in their skin before their transition* – which is the act of aligning appearance and gender expression with gender identity.

Transitioning through various social and medical steps affects many areas of a person’s life and can include changes to their skin. Some of these are known, but some are unexpected. This is why we’ve worked closely with, and funded research, from leading experts in transgender health to create a guide on what skin conditions may appear during a transition, and how they could be navigated.

* Source: The Diversity Standards Collective for Channel 4 & E45 (sample: 50 members of the trans community)

The content on this page is rooted in expert knowledge from healthcare professionals* within transgender healthcare. After screening over 500 research papers and following a robust quality assessment, this funded study** with key opinion leaders, evolved into a paper which signposts to the most reported skin changes during different stages of transition journeys.

We appreciate this may mean that there are some limitations, including age and some ethnic groups, but these limitations are here due to the very limited research which has been done in this space to date. This is why we feel it’s important to provide more resources and information for those who may need or want it.

Aside from research, we also collected personal stories from members of the community, to help everyone understand a little more about skin changes during transition. We hope it helps more trans+ people feel a little more comfortable in their skin.

* Professor Jon Arcelus, Emeritus Professor in Mental Health and Wellbeing, Nottingham University, Professor Walter Bouman, Honorary Professor School of Medicine, University of Nottingham and Dr Kamilla Kamaruddin, GP in Transgender Healthcare & Clinical Lead, East of England Gender Service, Cambridge
**Arcelus J, Kamaruddin K & Bouman W. P. Dermatological Aspects of Gender Affirming Medical Treatment in Transgender and Gender Diverse People: A Systematic Review, International Journal of Transgender Health (Submitted).

The research E45 has supported

E45 has worked with leading experts in transgender healthcare to carry out a literature review. This review starts with analysing existing published studies on skin conditions that may occur during different stages of medical and social transition journeys.

After screening over 500 research studies, and following a robust methodology, this paper describes the most reported skin changes that may happen during transition journeys. The paper itself is limited by the available studies, which in this case means, there are a lack of studies in different populations and within different ethnic groups. While the formation of this paper is a positive start, it has become clear that these limitations need to be addressed, and further studies are required.

Our role is to provide the information we have learnt, in order to advise the trans+ community of these possible skin changes. We also want healthcare professionals to have this knowledge to-hand so they can help their patients in the best way.

This leaflet talks about some of the most common skin changes that may occur during the transition journey

This leaflet is for the use of Healthcare Professionals only, and offers information on common skin problems that patients may experience during the transition journey

This is my Space – Winner of Channel 4’s Diversity In Advertising Award

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We’re incredibly proud to have won Channel 4’s Diversity in Advertising Award, created to encourage greater representation of diverse communities in advertising.

In our mission to help everybody feel comfortable in their skin, we believe it’s important to recognise the often harsh realities of people who don’t.

We worked together with trans, non-binary and gender diverse individuals to amplify misrepresented LGBTQIA+ voices and offer practical skin support.

Understanding skin changes from…


Testosterone therapy


Oestrogen and Anti-androgen therapy


Gender affirming surgery


Social transitioning