Objective: To describe the development and testing of a theory-based interview guide. To increase awareness of adulterated silicone use among Transgender. Design: A qualitative study based on semi-structured interviews. Setting: Interviews were conducted in Chicago, Illinois, USA. Method: Seven transgender adults aged 18 and over were interviewed using grounded theory method and an interview guide created for this study. Results: Participants perceived that adulterated injection liquid silicone is used widely among transgender as a cheaper means to augment physical appearance. The prevalence of illicit silicone is widespread among vulnerable, minority populations and is associated with health complications. Conclusions: Several health-promotion issues were discovered. These included the need for safer transition options, the need for more cost effective transition options, the need to collect surveillance data, and the need for health promotion and action research. (Contains 1 table.)