Diseases Produced by Silicone Injections to Modify Body Contour

Hospital de Clínicas “José de San Martín” Buenos Aires University (UBA), Argentina.

From September 18 to 21, 2018, the Faculty of Medicine at “José de San Martín” Hospital at the University of Buenos Aires held the first intrainstitutional silicone awareness week, on the multidisciplinary approach to diseases caused by the injection of silicones and other oils to modify the body contour.

It was organized by Dr. Gustavo Emilio Schenone under the auspices of an educational crusade, promoting free health access for those who have had silicone or other industrial oils injected into them for cosmetic, all of which are toxic materials, not authorized for this purpose by the Argentine Republic’s National Administration of Drugs, Food, and Medical Technology (ANMAT).

Targets of the Intervention: Sex and Gender

The demand for silicone injections arose both in “cis” women (those whose gender identity corresponds to that assigned at birth) and in “trans” women (users whose identity does not correspond to the gender they were assigned at birth).

In this sense, it is possible to define the concept of “sex” as a medical category based upon a set of biological characteristics, which include one’s genitals, hormones, chromosomes, and secondary sexual characteristics. It refers to congenital anatomical differences inscribed in one’s body. Meanwhile, “gender” refers to an individual’s social identity, constructed from their personal, subjective experiences. The World Health Organization (WHO) defines gender as a set of socially designed roles, behaviors, activities, and attributes considered appropriate for men and women. Thus, from an early age, different expectations are assigned to boys and girls—like the way they dress, the games they play, the toys they are gifted with, their manners, and their ways of thinking and behaving—which are not the product of natural, invariant hereditary processes but social and family constructions. Gender is, therefore, a construct that enables the elaboration of different identities. Moreover, it is influenced by two separate forces: social forces that try to assign individuals to one gender or the other and the individual’s own choice.

In this sense, the National Gender Identity Law, No. 26743, sanctioned and enacted in Argentina in May 2012 argues that “it is the internal and individual evidence of gender as each person feels it. It includes the personal experience of the body. It may or may not correspond to the sex assigned at birth.”

In our society, gender and sex are considered in binary terms, that is to say, using a classification system that divides each demographic characteristic into two categories. For sex, those categories are initially girl and boy and, later, woman and man. For gender, those categories are male and female. This latter definition assigns partially arbitrary roles, not promoting identities outside of that duality, ignoring the possibility that there are more than two gender choices. In this sense, it is essential to bear in mind that, within the healthcare system, people must be respected at all times and they must receive dignified treatment wherever they are being assessed or treated.

Social Networks

“Network” is classically defined as a mesh of threads, ropes, or synthetic fibers that has different uses and functions, depending on the material used during its conception, as well as shape, size, and other characteristics. When this structure is applied to society, we understand it as a social structure composed of actors (individuals, organizations, institutions) who are related according to some criterion that links them (kinship, friendship, commercial/professional relationship, religious affiliation, etc.).

In the population served in the crusade that we have initiated, dysfunction in the primary support network is perceived as the absence of the support needed for a person to have shelter and achieve full development, often because their gender is contrary to that which is expected of them. Domestic units are often not capable of providing such individuals the material resources they need or the emotional support that is essential for their development. In these cases, the family as a social institution enters into crisis, pitting the traditional patriarchal model by which gender stereotypes, roles, and rigid roles are assigned by the family against one family member’s own internal desires and needs. This conflict often drives away or actively expels those who do not conform to the expectations of their parents, uncles, grandparents, brothers, etc.

Many among those whom our crusade seeks to assist report having moved from smaller towns to larger cities, or even having immigrated from some other country to Argentina, seeking refuge in anonymity that allows them to leave behind a past filled with rejection, abuse, and emotional discomfort. It is the transition of a careful childhood, hiding sensations and feelings, into an adolescence governed by postponed desires.

So many have opted, from a very young age, to support themselves economically by prostitution. Some say prostitution allowed them to pay for their treatments and education, some of them with university careers.

In this context, the need of every human being to be welcomed by a group of peers that sustains and cushions the dynamics of life becomes apparent. In order to do so, some construct substitute networks that have, as a common factor, elected friendship links, professional collectives that contain more complex organizational structures capable of representing the rights of this vulnerable sector of the population. This structure favors the satisfaction of basic needs, provides emotional support and intergenerational solidarity, favors the development of one’s potential, and promotes active adaptation to the environment.

Health Issues

Access to clandestine therapeutic injections of liquid silicone and industrial oils offers expected, immediate aesthetic results, which is an advantage for those who choose it. They were drawn towards the lure of a simple, minimally invasive, ambulatory procedure, without being warned about future complications.

Others were warned about the potential (physical and emotional) of both intermediate- and long-term sequela from these injections. However, facing the dilemma of continuing to live in self-conflict with their self-determined gender versus embracing their transgender status, they chose to violate their bodies, guided by the aesthetic image they sought.

As told by some of those we interviewed, the desire to obtain their desired body image led them to quick and impulsive actions, often driven by a desire to belong. This is why they exposed their bodies to sordid, inappropriate environments (kitchens, offices, workshops), advertised and promoted on the sly, where they received treatments that could retain their low cost because of the sharing of supplies among several recipients.

Part of the population we have treated executed these bodily changes two decades ago, while going through adolescence, with the sole purpose of transforming their body, both to respond to their self-perceived desire and to optimize it as a consumer resource in the sex trade. For some who elect for prostitution, there are two motivations: on one hand, working as a prostitute helps to satisfy their desire to be viewed as an object of seduction within their desired gender; on the other hand, it is often the only way available to them to financially support themselves in a labor market that rejects the transgender population.

Conversely, there are those we interviewed who belonged to the middle or upper socioeconomic sector, having regular jobs, solid family structures, and contacts, who were the beneficiaries of prepaid medications and society’s social network. They agreed to treatments with liquid silicone, while paying amounts similar to those that the market has established for conventional surgeries and other treatments in formal healthcare settings.

These users reported having been subsequently assisted in private health environments by medical professionals and plastic surgeons who were not trained in the diagnosis and treatment of the physical and psychological consequences of past injections with silicone or other oils.

The experience gained during this week of awareness of the diseases produced by silicone injection clearly shows that there is a need for these patients and their group to be heard, contained, and assisted by the health system.