Case for a theory-based injection liquid silicone prevention policy: Promoting transgender adolescent health

Objectives. This mixed methods study examined prevalence of injection silicone behavior among 15 transgender adolescents and adults in Chicago, IL.

Methods. An exploratory study of interviews and surveys was designed to collect baseline prevalence data on injection silicone behavior. Grounded theory, health belief model, and social change theory were the conceptual models for data collection.

Results. Integration of mixed methods findings indicated that participants inject silicone to feminize or masculinize appearance. More than half of participants responded that silicone use was common. Positive HIV or AIDS status and silicone use was reported. Although knowledgeable about shifting, allergic reactions, systemic complications, and even death, transgender continue to inject silicone for cosmetic enhancement. Injection sites included face, breasts (MTF), chest (FTM), buttocks, and hips.

Conclusions. Mixed methods design was an effective framework to ensure investigative rigor. Transgender peer-led community outreach is critical to assess and prevent widespread injection silicone use. The health department must collaborate with the transgender community to increase awareness and promote silicone harm reduction initiatives to reduce injection silicone behavior. Health policy and a trans-focused health education module emerged from the results.