In a world where there is a greater onus on brands to speak out on and get involved in social issues, research can play a vital role in helping them to connect with diverse and marginalised groups in a more authentic way. Arguably there are few more marginalised and demonised in mainstream discourse than the trans community.  

In 2024, UK pharmacy staple E45 launched an advertising campaign focused on the skin changes trans people experience during the transition process. As well as a TV advert, the project included an information leaflet and online guide, and the publication of a research paper that was presented at a major trans healthcare conference. E45, owned by Karo Pharma since 2022, also won a Channel 4 Diversity in Advertising Award for the six-week TV campaign. 

Market research and academic research played a key role in the development of the campaign. According to Virginia Melis, global healthcare professional marketing lead at Karo, the company was keen to speak to the trans community on a topic it has considerable expertise in, and also to feature a more nuanced and positive portrayal of trans people. “We wanted to portray different usages of the products and occasions by different people,” says Melis. “That was incredibly important for us in the space of being an ally of the community.” 

E45 began by examining existing academic research into skin issues during transition as part of a literature review. The team expected that the review of the issue – which has been relatively understudied – would only uncover a small number of papers referencing skin during the transition.  

However, this estimate proved wide of the mark, with more than 500 papers identified during the review, which was later presented at a conference held by the World Professional Association for Transgender Health. Academics involved in the work included Jon Acelus and Walter Bouman at the Nottingham Centre for Transgender Health, and Dr Kamilla Kamaruddin, GP in transgender healthcare and clinical lead, East of England Gender Service, Cambridge. 

The research identified several conditions that E45 has since included on its website and a leaflet on skincare during transition, including issues related to gender affirming surgery, social transitioning, testosterone therapy and oestrogen and anti-androgen therapy. “There are conditions that a GP should be talking to their patients about,” says Melis. “But if you look at the NHS pathway, because of very serious issues that can occur within the health of the patient, skin is not covered at all.”  

The information leaflet was an important test of the language E45 used to describe the experiences of the trans community. “I was very focused on learning the language with the community,” explains Melis. “It’s a journey – when you are not in the community, this is one of the things you need to be really aware of. It’s about the context, the culture, and language is such a big piece of it.” 

The next part of the research was carried out in two stages. The first was an online survey with 200 consumers from within the trans community, recruited and run by research company The Diversity Collective, which had access to trans community members and was therefore able to bring in participants quickly. The survey covered how participants felt about their transition, the skin changes they experienced and how they coped with those skin changes, and included the leaflet as stimuli, as well as asking whether the leaflet affected participants’ perceptions of the brand. 

In phase two, a focus group of five trans professionals  from industries such as marketing, discussed the imagery, language and other aspects of the leaflet. Their input was especially detailed, Melis says, and challenged several aspects of the stimuli the brand presented. “The professionals were quite brutal,” adds Melis. “They were very challenging. Among those five people there were also slightly different views – they weren’t necessarily on the same page, and that was because they were discussing how these experiences were so personal to each of them.”  

The research helped E45 to make appropriate changes to its leaflet based on the feedback provided, but the overall results indicated a broad level of support from the trans community for E45’s campaign, according to Melis. The campaign focused on telling ‘real stories’ to its audience, which the survey results helped to support, especially around the personal nature of the transition process.  

Creative agency T&Pm produced the advertising campaign, with 4Studio, Channel 4’s content and social division, also helping to produce additional programming to tie into the advert launch. Ad awareness, according to YouGov measurement, was up 104% in the first month of the campaign, and brand awareness rose 6.3%, with May 2024 seeing the brand’s highest level of purchase intent for the year. The campaign content on the website was the most visited page on the E45 website.  

“Diversity is not just about good casting – it is context, culture and understanding the things that are important to the community,” Melis says. “The attention to detail has been incredibly important.”  

Melis also argues that, in a more polarised world, it is vital that brands are prepared to stick their neck out to support marginalised groups, regardless of any potential backlash from other sections of society. “In the last few years, brands have taken a bit of a step back, so there is a responsibility from brands considering the influence they have on consumer minds and how they can influence." 

“Misrepresentation has really impacted the [trans] community. A brand could really change perceptions and help make a cultural and informative shift in society.” 

*Image is from E45 website covering Skin Through the Transition