Washington Blade - September 12, 2003
Bryan Anderton

These and other recent cases are shedding light on the phenomenon of trans people, particularly male-to-female, using illegal silicone injections to alter their bodies rather than undergoing hormone therapy or professional cosmetic surgery.

In this process, industrial grade silicone - sometimes mixed with other materials such as paraffin and oil - is injected directly into the breasts, hips, buttocks and other areas. The injections can cause long-term health problems and, in some cases, prove fatal.

"That's been going on for years," said Earline Budd, a local transgender rights activist. "But nobody's willing to talk about what's going on - [not] the girls who are getting the work done, and definitely not those who are doing the work."

Sharon Snider, a spokesperson for the Food & Drug Administration, said silicone injections were not approved for any cosmetic use in the United States.

Once-popular silicone breast implants - in which silicone gel is encased in a rubbery shell and then implanted into the breasts - were taken off the market in the early 1990s, and are now only available through participation in clinical studies.

The injections have a number of perceived advantages over more conventional surgeries or hormone therapy, according to Jessica Xavier, another D.C.-area transgender rights activist. The injections are relatively inexpensive and produce immediate results. They also allow male-to-female transgendered people to maintain their sexual virility, which is important for those who work in the sex industry.

About 19 percent of transgendered women in D.C. have had these illegal injections, according to a Washington Transgender Needs Assessment Survey completed in 2000. Xavier estimated that percentage was closer to 25 percent currently.

The most common injections among male-to-female transgendered people are in the breasts, hips, buttocks and cheekbones, Xavier said, while some female-to-male transgenders opt to have their pectoral muscles or their calves "pumped up."

Dying for a new body

Most people who have these injections don't realize the dangers involved, activists said.

"They're deadly," Xavier said. "But it's very similar to cigarette smoking, something that's going to kill you 25, 30 years later."

Dr. Morad Tavallali, a local board-certified plastic surgeon, said people can have an allergic reaction to the silicone over time, causing pain and redness in the injected area. After some time, the silicone can also form granulomas, or hardened inflamed nodules, inside the body where it was injected. If that happens, the silicone user may have to resort to drastic measures.

"It's like they've got hard rocks in their breasts," Tavallali said. "And the only thing to do then is to perform a mastectomy."

It is also not uncommon for the silicone to become dispersed into small droplets and spread over the localized area. Once the silicone has spread, it is virtually impossible to surgically remove it all, Tavallali said.

But the silicone doesn't always just cause health problems over the course of years. Sometimes, it can be immediately fatal.

"What's happened in some of these recent deaths is the practitioners weren't careful about where they were injecting," Xavier said. "If you put silicone into a vein, it can kill you instantly, because it will travel to the heart and cause a heart attack or a stroke."

A recent medical advisory from the group Gender Education and Advocacy, Inc., warned of other effects from the injections, as well.

"While appearance may be enhanced on the short-term, most silicone injection is ultimately disfiguring, as the silicone migrates, changes shape, or hardens. Once injected, silicone is impossible to remove completely, and extensive scarring accompanies even partial removal. Silicone injected in the breast area makes mammograms ineffective, and often requires bilateral mastectomy," the report said.

It also went on to state that the injections could lead to medical problems - including respiratory distress, toxic shock syndrome and cancer, among many others - while the use of non-sterile needles increases the risk of transmitting HIV, hepatitis and other infectious diseases.

The injections have been performed everywhere from private homes to hotel rooms to back alleys, and are usually not performed by a licensed medical professional. In Florida and other places, so-called "pumping parties" have become popular, where a host will inject a number of people with silicone in the same sitting.

Most people who opt to have the illegal injections find out where to get them through word-of-mouth, Budd said.

"It's just like sending a news announcement out, 'Someone's having a silicone party,' " Budd said. "Everyone knows about it."

Xavier, meanwhile, said she had not heard of any "pumping parties" in D.C., but that there were a number of silicone "providers" in the area and that some people even inject silicone into themselves.

Tavallali warned that the risks involved with the illegal injections were not worth the possible complications that could arise over time.

"I cannot say enough bad things about these silicone injections," Tavallali said.

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