A Body-Neutral and Gender-Neutral Modified Ferriman-Gallwey Diagram

J Pediatr Adolesc Gynecol. 2022 Jun;35(3):375-378. doi: 10.1016/j.jpag.2021.10.015. Epub 2021 Nov 5.


Background: The modified Ferriman-Gallwey (mFG) diagram for scoring hirsutism uses images with traditionally Eurocentric feminine features. No reports have documented its utility in patients with other gender identities.

Case: A 16-year-old nonbinary masculine patient, assigned female sex at birth, was seen for hyperandrogenism and irregular menses. They declined an exam, citing body dysphoria, and declined self-documenting on the mFG diagram, expressing anxiety with gendered images. We subsequently developed a novel, gender-inclusive mFG diagram, which the patient was then comfortable using to document their hair pattern.

Summary and conclusion: This case documents how the binary gendered characteristics of the mFG diagram can impact the care of patients. As gender expression is highly individual, we created the first gender-inclusive version of the mFG diagram to enhance care for all patients.

Keywords: Body image; Body positive; Diagram; Gender dysphoria; Gender neutral; Hirsutism; Hyperandrogenism; Irregular menses; Modified Ferriman-Gallwey; Transgender; Transmasculine.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Female
  • Gender Identity*
  • Hair
  • Hirsutism
  • Humans
  • Hyperandrogenism*
  • Infant, Newborn
  • Menstruation Disturbances