Seriously, AFAIK, it rarely "worsen". There are many cases in porn (Dredd, Brickzilla, Danny D - lightly -, Brick Danger, Alexander TdA), even among trans models (Yasmin Dornelles, Laura Saenz, Fabiola Voguel, Stefany Heaven, Patricia Bacelar...) sometimes even more pronounced (Castro Supreme, if you remember him).