Epidemiology and clinical outcomes of filler-related complications among transgender women in Mexico
Abstract
Filler-related complications (FRC) arise from the injection of high-density substances used to modify the body in order to harmonize gender identity and/or gender expression and represent an emerging public health problem. Among transgender women, limited access to gender-affirming healthcare, together with other psychosocial, structural, and social factors, may contribute to the use of body modification practices intended to harmonize gender identity and gender expression, including the use of injectable materials. We conducted a retrospective analytical study among transgender women with a history of filler injections receiving care at three public referral centers in Mexico City between September 2024 and July 2025. Participants were identified through review of available clinical records and transgender care registries. Transgender identity was determined based on self-identified gender documented in the clinical record and confirmed through clinical chart review. Demographic, clinical, and social variables were collected to characterize FRC and associated factors. FRC were defined as documented inflammatory, infectious, migratory, or mixed manifestations temporally associated with prior filler exposure and attributed by the treating clinical team to filler injections. A total of 222 transgender women were included, with a median age of 45 years (IQR 38–52). Overall, 99 participants (44.5%) were classified as having FRC, most commonly inflammatory or mixed presentations. Materials referred to as “biopolymers” were the most frequently reported injected substances, followed by injectable oils, and among participants with available information, 93% of injections were performed by non-medical personnel. The time between filler injection and symptom onset exceeded 5 years in 54% of participants with FRC. More than one-third of affected participants required hospitalization attributable to FRC. Nearly half of transgender women with prior filler injections experienced complications, underscoring the substantial morbidity associated with filler injections performed outside supervised medical care. These findings highlight the multifactorial structural and social context surrounding non-medically supervised filler use, including barriers to gender-affirming healthcare, and the need for multidisciplinary care pathways for FRC. Because this retrospective study was conducted at referral centers, severe complications may be overrepresented.
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BibTeX
@article{maranonsolorio2026epidemiology,
title = {{Epidemiology and clinical outcomes of filler-related complications among transgender women in Mexico}},
author = {Karen Aranza Marañón-Solorio and Mariana Vélez-Pintado and América Sarahí Martínez-Frías and Esmeralda Román-Mar and Mitzi Zaira Fong-Ponce and Montserrat Staeps-Gordoa and Juanita Lastra-Torres and Elizabeth Vancini-Nieto and María Eugenia Zghaib-Rivero and Paula Viveros-Wacher and Alvaro López-Iñiguez and Alfredo Ponce-de-León and Fernanda González-Lara},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-75908-z},
url = {https://www.nature.com/articles/s41598-026-75908-z},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Epidemiology and clinical outcomes of filler-related complications among transgender women in Mexico
AU - Karen Aranza Marañón-Solorio
AU - Mariana Vélez-Pintado
AU - América Sarahí Martínez-Frías
AU - Esmeralda Román-Mar
AU - Mitzi Zaira Fong-Ponce
AU - Montserrat Staeps-Gordoa
AU - Juanita Lastra-Torres
AU - Elizabeth Vancini-Nieto
AU - María Eugenia Zghaib-Rivero
AU - Paula Viveros-Wacher
AU - Alvaro López-Iñiguez
AU - Alfredo Ponce-de-León
AU - Fernanda González-Lara
PY - 2026
DA - 2026/10/14
JO - Scientific Reports
DO - 10.1038/s41598-026-75908-z
UR - https://www.nature.com/articles/s41598-026-75908-z
AB - Filler-related complications (FRC) arise from the injection of high-density substances used to modify the body in order to harmonize gender identity and/or gender expression and represent an emerging public health problem. Among transgender women, limited access to gender-affirming healthcare, together with other psychosocial, structural, and social factors, may contribute to the use of body modification practices intended to harmonize gender identity and gender expression, including the use of injectable materials. We conducted a retrospective analytical study among transgender women with a history of filler injections receiving care at three public referral centers in Mexico City between September 2024 and July 2025. Participants were identified through review of available clinical records and transgender care registries. Transgender identity was determined based on self-identified gender documented in the clinical record and confirmed through clinical chart review. Demographic, clinical, and social variables were collected to characterize FRC and associated factors. FRC were defined as documented inflammatory, infectious, migratory, or mixed manifestations temporally associated with prior filler exposure and attributed by the treating clinical team to filler injections. A total of 222 transgender women were included, with a median age of 45 years (IQR 38–52). Overall, 99 participants (44.5%) were classified as having FRC, most commonly inflammatory or mixed presentations. Materials referred to as “biopolymers” were the most frequently reported injected substances, followed by injectable oils, and among participants with available information, 93% of injections were performed by non-medical personnel. The time between filler injection and symptom onset exceeded 5 years in 54% of participants with FRC. More than one-third of affected participants required hospitalization attributable to FRC. Nearly half of transgender women with prior filler injections experienced complications, underscoring the substantial morbidity associated with filler injections performed outside supervised medical care. These findings highlight the multifactorial structural and social context surrounding non-medically supervised filler use, including barriers to gender-affirming healthcare, and the need for multidisciplinary care pathways for FRC. Because this retrospective study was conducted at referral centers, severe complications may be overrepresented.
SN - 2045-2322
ER -