Healthcare

Pharma Giant Behind Botox, Breast Implants Bankrolled Doctors Pushing Trans Cosmetic Procedures

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• Allergan Aesthetics, a pharmaceutical company whose products are used in cosmetic procedures, has funded research promoting cosmetic treatments as particularly helpful for transgender people. 
• The company produces neurotoxins and other facial injections, as well as breast implants, and has financially supported doctors who administer those procedures for transgender patients or who are involved in research on the treatments’ impact on transgender people. 
• “This isn’t the 65-year-old woman who comes in complaining of marionette lines or brown spots on her face. These are individuals who very deeply know that they are in the wrong body,” one researcher who received payments from Allergan wrote about transgender patients seeking cosmetic treatments. “It’s medically necessary, ethical care that will help adolescents affirm who they are.”

Allergan Aesthetics, a pharmaceutical company that produces Botox injections and breast implants, funded doctors who promote cosmetic procedures as particularly beneficial and even medically necessary for transgender people.

Allergan has been quietly funding research that promotes neurotoxin injections and injectable facial fillers, which the company produces under the labels Botox and Juvederm, for transgender people. The company has also paid hundreds of thousands of dollars in consulting and public speaking fees to doctors who are involved in this research, or who offer transgender cosmetic procedures that may involve Allergan products, according to a Daily Caller News Foundation investigation.

One Allergan-funded 2021 study on the effect of minimally invasive facial cosmetic procedures for transgender individuals — such as the injectable facial fillers and neurotoxins produced by Allergan — concluded that “facial procedures can be of great benefit in enhancing patients’ self-perception and overall quality of life” and highlighted “the success of minimally invasive methods for assisting transgender patients in their facial remodeling goals and in the progress of their transition journey.”

The study has been cited nine times, according to Google Scholar. The study was not only funded by Allergan, but all seven doctors behind the research had ties to the company as advisory board members, investigators or paid consultants except for one who was both an employee and stockholder, according to the study. One of the authors, Dr. Terrence Keaney, has received more than $436,000 from the company since 2015, and another author, Dr. Alexander Rivkin, received more than $323,000 in the same time frame, according to data from the Centers for Medicare and Medicaid Services (CMS).

Advocates of cross-sex surgeries have successfully branded the procedures as medically necessary by arguing that, without them, transgender people are less satisfied with their lives and more likely to commit suicide. Medical industry leaders in recent years have pushed to add cosmetic procedures, including facial contouring and laser hair removal, to the growing list of treatments considered medically necessary for transgender people, which could line the pockets of pharmaceutical companies and medical providers by forcing insurers to cover them, according to a previous DCNF report.

Allergan has similarly funded doctors who have pushed the narrative that cosmetic procedures involving the products Allergan sells have powerful benefits for transgender people.

Allergan has given thousands of dollars to various medical doctors including Dr. Lauren Meshkov Bonati, a dermatologic surgeon who performs transgender aesthetic procedures. Bonati was listed as the lead author of a 2021 study which found improvement of gender perception and quality of life for transgender people who had undergone neurotoxin and soft tissue fillers, both of which Allergan produces. 

“This isn’t the 65-year-old woman who comes in complaining of marionette lines or brown spots on her face. These are individuals who very deeply know that they are in the wrong body,” Bonati told Dermatology Times for an article about her study. “It’s medically necessary, ethical care that will help adolescents affirm who they are.”

Allergan paid Bonati more than $16,000 from 2016 to 2021, mainly in consulting fees, according to CMS data.

“Medical practices, hospitals and pharmaceutical companies are always looking for profitable markets for their services,” Joseph Burgo, psychotherapist and vice director of Genspect, told the DCNF. “I can’t think of any other reason why Allergan would be providing financial incentives to doctors who research and work in this space: they’ve identified a profitable market niche and are exploiting it, as any for-profit business will do. Does anyone believe it because they want to be ‘trans allies’ or on the right side of history? Don’t make me laugh.”

The company gave more than $112,000 from 2017 to 2020 to Dr. Jeffrey Janis, former president of the American Society of Plastic Surgeons (ASPS), mostly as compensation for consulting and faculty or speaker fees, according to CMS data. The ASPS lists “supporting sustained or increased gender affirmation surgical coverage” among its legislative priorities. ASPS’s journal, PRS Global Open, added a “Gender Affirming Surgery” section while Janis was its editor-in-chief.

Allergan also paid plastic surgeon Dr. Mark Youssef $108,000 from 2015 to 2021 as payment for unspecified services which may have involved a role as a public speaker, according to CMS data. Youssef is the president of the Transgender Surgery Institute of Southern California, and his name appears frequently in online guides to transgender surgeries.

Other medical industry leaders are promoting transgender cosmetic procedures and pushing to have them considered medically necessary for insurance purposes; the American Society of Plastic Surgeons has fought against state legislation restricting child sex changes, and Johns Hopkins Medicine has lobbied Maryland to extend Medicaid coverage to transgender cosmetic procedures they offer.

AbbVie, the pharmaceutical giant that produces the puberty-blocking drug Lupron, acquired Allergan for $63 billion in 2019.

Allergan, Keaney, Rivkin, Bonati, Youssef and Janis did not respond to the Daily Caller News Foundation’s requests for comment.