trans men who have the reproductive organs they were born with have the potential to become pregnant whether they are on testosterone or not, under the previous patient classification model the iPLEDGE program required that transgender patients register based on their gender assigned at birth. This meant that the iPLEDGE program required trans men be misgendered as female in order to gain access to isotrenoin in the United States. A proposed solution was for iPLEDGE to make their classifications of patients gender neutral; instead focusing on the potential to become pregnant. Effective December 13, 2021 iPLEDGE adopted gender neutral patient categorizations as recommended by The American Academy of Dermatology. Criticisms of the iPLEDGE website and phone system Some criticisms of the iPLEDGE website include that the website does not clearly identify who administers the site, despite being a mandatory program that requires the submission of private information about medical patients. The terms of use and legal disclaimer section of the site do not clearly identify the legal entity running the program or describe how the private information of the patients is secured. The terms of use for the site is phrased as a contract between "you" and "the sponsors of the Site" (which it defines as synonymous with "iPLEDGE"), without clearly saying who "the sponsors of the Site" includes. The program was mandated by the FDA despite criticism from practicing medical doctors that its cumbersome nature and strict deadlines can make the drug unavailable to deserving patients. In practice, the website has presented many problems to physicians; once information is entered, it can be difficult or impossible to change or correct it. If there is an error, the patient can be locked out for 30 days without being able to receive the medication. Problems are common and take days to correct. Technical assistance by phone is available via a toll free number, but trying to correct problems using the phone system can be difficult and time-consuming. Cathy Boeck, a past president of the Dermatology Nurses Association, said "Nurses are having the same frustrations as doctors regarding difficulties of getting the drug to patients and patients' complaints. It has a huge impact on resources if someone is waiting on hold with iPLEDGE and is also taking calls from patients who are upset and frustrated. That’s what we’ve heard from members." Although the goal of the program is to prevent pregnancies of