Remote, participant-acquired images for acne research in transgender and gender-diverse individuals: A prospective cohort study

Summary: Abstract Body: Transgender and gender-diverse (TGD) patients face a high acne burden, yet remain underrepresented in acne research. Remote participant-acquired photographs may reduce barriers to research participation for TGD individuals, but feasibility data remain limited. This prospective cohort study aimed to describe the feasibility of obtaining participant-acquired photos (frontal, left, and right face, chest, and back) using interim results from an ongoing acne-specific study. Participants were recruited in academic dermatology and endocrinology clinics and a multidisciplinary gender center at a public hospital. At enrollment, participants received equipment and instructions for standardized image collection and secure submission at baseline, 1, 2, and 3 months. Feasibility was defined as the proportion of images deemed acceptable on initial review by trained reviewers who assessed images for blurriness, zoom, and proper labeling. Images requiring corrections were resubmitted. Twenty-two participants were enrolled (mean age 27.6 (6.9) years): 73% self-identified as transgender male or male, 23% as genderqueer or other, and 5% as transgender female. A total of 440 image submissions were made, of which 97% were acceptable upon initial upload. Thirteen images (3%) required resubmission, most commonly due to blurriness (38%) or improper distance (38%). Other resubmission reasons (62%) included filters (38%), missing images (15%), and mislabeling (8%). Left-face images had the highest resubmission rate (31%). Participant-acquired photos proved feasible with adequate quality for prospective remote research or clinical trials in a cohort of transgender and gender-diverse individuals. Study limitations include the single-center design and lack of a validated photo quality assessment. Future studies should evaluate whether participant-obtained photos consistently meet quality standards for reliable clinician assessment. Anna Pulminskas¹, Courtney A. Smith¹, Ketki Joshi¹, Julia Rogers¹, Chelsea Deitelzweig¹, Emily Gosnell¹, Emma K. Kitchens¹, Ferris Abu-Ghosh¹, Kalina Machado¹, Howa Yeung¹ 1. Dermatology, Emory University, Atlanta, GA, United States. Minoritized Populations and Health Disparities Research