Navigating Ipledge Enrollment for Transgender and Gender-Diverse Patients: A Guide for Providing Culturally Competent Care

To the Editor: Acne is a common condition among transgender and gender-diverse individuals, but the mandatory iPLEDGE program for monitoring isotretinoin treatment is insensitive to this population.1,2 The US Food and Drug Administration implemented the iPLEDGE risk evaluation and mitigation strategy program to prevent pregnancy while taking isotretinoin, a teratogenic medication. In iPLEDGE, providers must register patients as either male or female rather than solely by their reproductive potential.