When Ashley Phillips was referred to dermatologist Jennifer MacGregor by her primary doctor, Phillips was skeptical. Board-certified in dermatology and fellowship-trained in laser, cosmetic, and dermatologic surgery, MacGregor is both highly qualified and sought after as a care provider at Union Square Laser Dermatology in New York City. But as a trans woman looking to present more feminine, Phillips didn’t understand how MacGregor could help her. “In the beginning, I said, ‘Well, it’s a dermatologist, what could she do?'” she recalls.
Phillips scheduled an appointment anyway. Six months later, the 39-year-old says the noninvasive treatments MacGregor has provided her have transformed her self-image, and she’s eager to show other trans folks the potential of these procedures to alter gender presentation. “There are so many different things that she has done for my face that just amaze me,” remarks Phillips.
She had assumed she could only achieve a more feminine look with facial feminization surgery, a set of surgical procedures that can include rhinoplasty, cheek implantation, or forehead reduction, but was surprised to discover other possibilities, thanks to the doctor. Phillips says, “From the first time that I saw [MacGregor], the Botox and the injectables just [on] the first day totally changed my whole outlook.”
Phillips has also undergone CoolSculpting, a noninvasive procedure that freezes fat cells, and UltraShape, a body-contouring procedure through the use of ultrasound. “My body has changed so much that the confidence that I have now totally, totally is [blown] out of the water compared to what I used to go through before,” she says. Recently, she ditched the bodysuit she had worn under her clothes since she began transitioning two years ago and went out in public wearing only a sports bra under her shirt.
Injectables, CoolSculpting, and UltraShape are all popular treatments among cis, trans, and gender-nonconforming patients alike, and MacGregor stresses that none of the procedures she performs are “trans-specific.” There are over 30 laser and energy devices at Union Square Laser Dermatology, she explains, as well as “a range of other procedures I offer to all of my patients.”
“All people benefit by presenting themselves in the world…in the way that individual feels matches with what’s on the inside,” she continues. “Facial injectables can be tailored to masculinize, feminize, or really just customize an individual’s goals: laser hair removal, laser resurfacing for acne (acne and scarring get especially [severe] in those taking testosterone) and surgical scars, and noninvasive body contouring for troublesome fat pockets or smoothing skin are also popular.”
The cornerstone of caring for any patient, she adds, is listening: “One thing I’ve learned from all of my patients is never to assume what they want, what they see in the mirror, or what their goals might be,” she says. “I simply ask what pronoun they [use], what facial and body hair pattern they prefer, what they see in the mirror they may wish to accentuate, minimize, and so on.” As she points out, gender identity alone doesn’t determine what a patient’s priorities will be: Either trans or cis men may ask to remove beard hair, for example, while both trans and cis women may prefer the look of a stronger jawline.
For transgender and gender-nonconforming people seeking care, this individualized, patient-led approach isn’t universal in the medical world — or even all that common, unfortunately. “It’s very hard to find people in the healthcare profession that will listen to trans folks,” Phillips explains. “I’ve gone to doctors that misgender me…You go to some places and they tell you what they think you should have. I’m not saying Dr. MacGregor doesn’t give you suggestions, because she does, and they’re amazing, but she’s also doing it based on what I feel.”