If you are one of the 200-500.000 trans people in the UK [2], you may have considered a transgender hair transplant to complete your gender affirmation process. If so, you are not the only one. People who transition from male to female often get hair restoration surgery as part of their facial feminisation. At the same time, those who transition from female to male may need it to enhance their face and body hair or to treat androgenetic alopecia triggered by their testosterone hormone therapy.
The good news is that there are many safe and effective surgical hair restoration options available to assist transgender people in affirming their gender identity. And the Wimpole Clinic has excellent results in all types of surgery, from hairline-lowering surgery to beard transplants, body hair transplants and more. This article will tell you all you need to know about:
The term “transgender” can encompass a variety of people with different bodies, needs and desires. Thus, there are also many distinct ways in which a hair transplant can assist each of them in affirming their gender and enjoying their appearance. Here are some of the most common hair concerns that restorative surgery can help trans people address:
Transitioning from male to female often involves undergoing female hormone therapy (i.e. taking oestrogens) to achieve a more feminine appearance. However, women’s hair growth patterns can differ from men’s. For example, the female hairline is normally lower, more even and more oval-shaped than the male one [3][4]. So, part of affirming your feminine identity may include lowering and reshaping your hairline.
Moreover, androgenetic alopecia affects most natal men before they reach the age of 50 [5]. Thus, if you were assigned male at birth, you may have started to develop a receding hairline or temple hair loss. Once you have transitioned to female, you may want to get a permanent hair transplant to fix this problem.
If you have transitioned from female to male, you are likely taking androgen hormone therapy (i.e. testosterone). Studies show that 76% of trans men develop some level of male pattern baldness after 2 years of testosterone treatment, and in 26% of them, this hair loss is moderate to severe [6]. While some people are comfortable with some frontal balding, as it is a typical male trait, others opt for a hair transplant to help preserve their youthful appearance.
Furthermore, despite taking male hormones, some trans men have difficulties growing sufficient facial, chest or pubic hair. Since many find beards and body hair to be defining of masculinity, using hair transplants to achieve this hair growth may help affirm their male identity and make them feel more comfortable in their body.
A hair transplant is performed in an outpatient setting, which means you won’t need to be hospitalised and can go home the same day. First, you will have a consultation with your surgeon, where you will agree on the shape of the receiving area, the number of hair grafts that will be used and the results you can realistically expect. You may be asked to get additional blood tests for hair loss and will be notified about the (low) potential risks of the procedure.
Hair transplants are normally performed under local anaesthesia, which numbs your scalp but doesn’t put you to sleep. You will be awake throughout the procedure but feel no pain. The medical team may also offer you a sedative to calm your nerves if you need one.
During your hair transplant, the surgeon will harvest some healthy hair from the back or sides of your head (or a different part of your body, depending on what kind of intervention you are getting). They may do so using a FUT procedure, where an entire strip of skin is harvested from your donor area and then cut into individual hair grafts.
Or you may opt for the more discreet and popular FUE procedure, where they will use a special tool to punch out individual hair grafts, leaving only micropunctures and no visible scar. Once extracted and prepared, the grafts will be implanted into small slits in the areas where you would like to grow more hair.
Once your surgery is complete, you will be properly bandaged, and your surgeon will provide you with all necessary hair transplant aftercare instructions. They will also let you know when you should come back in for your checkup.
Depending on the transition you underwent and the reason you need a hair transplant, you can get several kinds of procedures on different areas of your scalp, face and body. Here are some of the most popular options:
This type of surgery is designed to reshape your hairline, making it look more feminine (i.e. straighter and more rounded at the edges). In many cases, it also involves surgical hairline lowering, as women’s foreheads are usually narrower than men’s.
However, some trans women are happy with their forehead width or opt for forehead reduction surgery instead. Hairline feminisation doesn’t normally require a large number of grafts (unless you have frontal balding), and it can be performed at the same time as your facial feminisation surgery to reduce the number of procedures you need to undergo for gender affirmation.
This is a typical hair transplant performed for androgenetic alopecia. It involves taking hair follicles from healthy areas on the back and sides of your head and implanting them into the bald spots on your crown, or into the thinning areas around your temples.
Since the hair follicles in your donor area are not sensitive to dihydrotestosterone (DHT), the hormone involved in pattern baldness, your newly implanted hair should not be affected by androgenetic alopecia. This means you can enjoy your crown or temple hair transplant for decades to come.
This type of surgery works best when your baldness is not very extensive. If you have an advanced condition, you may not have sufficient hair follicles in your donor area to cover the entire thinning area.
If you are a trans man and would like to wear a beard and a moustache, you may sometimes find the testosterone therapy insufficient. Your facial hair may come in sparse, or it may not come in at all [8].
However, you can grow a fuller, healthier beard and moustache with a transplant. It doesn’t matter if the hair on your face is dwindling. The surgeon can harvest hair follicles from the back or sides of your scalp, where they grow thicker and implant them into your chin.
You will likely need about 500 grafts for each cheek and up to 800 grafts for your moustache [8].
Female eyebrows are normally thinner and more arched than male ones, and the arching is closer to the outer end of the eye [3]. So, an eyebrow transplant can help you achieve better density or change their shape to reflect the desired gender characteristics.
Scalp donor hair is usually preferred for this procedure, as it looks more natural and you have a larger donor area. However, this means that you will need to trim your transplanted eyebrows periodically, as they will grow longer than the ones you were born with.
Normally, 200-375 grafts will suffice for this intervention [3]. The procedure can be performed stand-alone, or it can be done at the same time as your hairline transplant surgery.
Some trans men struggle to grow thick, dense hair on their chests or their pubic areas. This can be distressing, as many associate masculinity with body pilosity. Moreover, hair can also help disguise scarring from a mastectomy or gender reassignment surgery.
However, you can always get a transplant to cover your chest using hair from your scalp. Similarly, a pubic hair transplant can help you better cover your genital area. However, keep in mind that these surgeries may require a substantial number of hair grafts. So, if you are planning on getting scalp hair and/or beard transplants, you may need to prioritise your procedures and choose those most important to you.
Normally, a moderately full chest area can require 2000-3000 hair grafts, while a pubic hair transplant would take another 900-1300 grafts [3].
The hair transplant risks faced by transgender people are normally the same as those of the general population. The most common of them involve [11]][12]:
You can reduce some of these risks by following aftercare instructions closely and by giving up nicotine at least 3 weeks before and after your procedure. That is because smoking can impact your hair transplant results.
You may be a good candidate for a hair transplant if you are a transgender person who has the following characteristics [13]:
Some say that it is a good idea to wait between getting facial feminisation surgery and rebuilding your hairline. However, researchers found that it is safe to have them both at the same time.
A study conducted in 2017 on 65 transgender women who had facial feminisation surgery alongside a hair transplant showed no complications and adequate hair density after 12 months [1].
Getting both these procedures at the same time can reduce the number of interventions needed for facial feminisation. It can save the patient the psychological stress and recovery time of going through two different surgeries and allow the entire upper third of their face to be reshaped at once.
Hair transplant costs depend on a variety of factors, such as the type of procedure you opt for, the number of hair grafts you need and the experience of the surgeon you have chosen. However, on average, you can expect a 1500 hair graft hair transplant to cost approximately £5000 in the UK.
Similarly, you can expect to pay, on average, around £4000 for a beard transplant and about £3500 for an eyebrow transplant. However, every clinic has its own pricing, and additional costs for extra services may apply.
While a hair transplant can be more expensive in the UK than abroad, it is also safer, and the results are often far superior. According to the British Association of Aesthetic Plastic Surgeons’ 2022 Practice Census Results, 100% of plastic surgery complications take place in Turkish clinics [14].
Many transgender people undergo several gender-affirming procedures, which can be taxing physically, psychologically and financially. However, if you decide that a hair transplant is something you need to feel comfortable and true to yourself, be sure to choose a good hair clinic which adheres to all safety regulations and professional good practices.
Take the time to choose your surgeon and ask them to see their portfolio before scheduling the procedure. That is because hair restoration surgery is a life-long investment in your self-image and appearance. And you need to be sure that something important to you is in your hands.
Yes, transgender people can achieve the same excellent hair transplant results as anyone who chooses to get this type of surgery. The best hair clinics in the UK have a 97-100% success rate, and most of their patients are fully satisfied, regardless of gender.
If you would like to see what the outcomes of some hair transplants performed on transgender people look like, here are a few examples from the scientific literature:
In the photographs above, a 37-year-old transgender woman had a hair transplant to fix a pronounced M-shaped pattern caused by androgenetic alopecia. She had already tried Dutasteride 0.5 mg and topical Minoxidil for 7 months, with no improvement. The 1750 graft FUE hair transplant was a visible success [7].
The trans woman above had a facial feminisation surgery, which included a simultaneous hairline feminisation transplant. It removed the signs of her temple hair loss and made her hairline softer, more even and more oval.
The trans man above was unable to grow facial hair through hormone therapy. A beard and moustache transplant helped him achieve satisfactory, masculine-looking facial hair, which contributed to their gender-affirming process.
The pictures above illustrate the transformation of a different transgender man who was only able to grow a sparse, patchy beard with hormone therapy. However, his beard and moustache were considerably thicker after a successful 1600-graft facial hair transplant.
The trans man above underwent a 2600 graft chest hair transplant, which not only made him look more masculine but also helped mask his mastectomy scars. The chest hair looks thick and dense and has a natural-looking distribution.
If you would like to try some non-surgical methods that can help treat or disguise a receding hairline or a bald spot on the crown, there are several good options out there. Here are some of the most common and effective:
If you are experiencing hair loss, you should see a trichologist and get their recommendation for the right hair growth medications. Minoxidil is largely safe and effective for all genders, as it works by dilating the blood vessels in your scalp so more nutrients can reach your hair follicles. However, if you are undergoing feminisation therapy, you need a lower dose (e.g. Minoxidil 2%) to avoid excessive facial hair growth [15].
Medications such as Finasteride and Dutasteride, used to treat androgenetic alopecia, can also be very effective and provide benefits for transgender men who undergo masculinisation therapy, as they work by decreasing your levels of DHT but not your testosterone [15].
However, at this time, there is insufficient research to determine how they interact with testosterone or oestrogen treatments. Since DHT is a much stronger androgen than testosterone, some researchers believe that reducing DHT production may block the development of wanted male secondary characteristics, so it should only be taken starting 2 years into testosterone therapy [11].
Trans women may benefit from taking a daily dose of spironolactone for hair loss. This treatment reduces the production of androgens, which is efficient in regrowing your hair and increasing its density and can help with the feminisation process at the same time [15].
If you would like to slightly change the aspect of your hairline or make your frontal scalp hair appear denser, you can get scalp micropigmentation (SMP). This is very similar to a tattoo – a specialised technician uses a high-speed tool to inject microdots of ink into your scalp, imitating your natural hair growth pattern.
SMP reduces the colour contrast between your hair and scalp and makes thinner areas appear fuller. This procedure is, however, not permanent, as it needs to be touched up every 6 months to avoid discolouration. Moreover, if you have certain shades of blonde or auburn hair, it can be difficult to find matching pigment.
A safe, temporary and non-invasive way of making your hairline or crown appear fuller is to use a hair-thickening spray. These products contain microfibers which attach to your natural strands, creating the illusion of increased volume and disguising thinning areas.
Some of these sprays can also be coloured, so you can get a shade that matches your hair, reducing the contrast with your scalp and making your hair seem denser. However, you need to be careful to select good quality, water-proof products to keep them from running down or rubbing off if you get wet or sweaty.
Getting a cute wig or hairpiece can be an instant morale boost. However, it can also be tedious to spend a lot of time fitting it perfectly, only to take it off at the end of the day. Fortunately, modern hair systems can be kept on for 3-6 months at a time, depending on their quality.
High-end products can look very natural, practically indistinguishable from your own hair. However, you will need to replace them 2-3 times a year to maintain the life-like look.
A good hairstylist can work magic when it comes to masking your problematic areas and emphasising your good hair qualities. You can simply get one of the best hairstyles for women with a receding hairline, a great female hair loss style for thinning hair on your crown or, in your case, the most impressive male hairstyles for a receding hairline. In most people, wearing bangs, side parts, or a zig-zag parting can often disguise the main signs of balding.
If you are considering getting a hair transplant to complete your gender-affirming process, book a consultation today with one of our world-class surgeons. You can do so at your most convenient central London clinic location.
Whether you need a scalp, face or body hair transplant, they will run all the necessary tests to determine if you are a good candidate and can truly benefit from this procedure. Then, they will walk you through the entire procedure, answer your questions and work with you to determine the best possible outcomes that will make you feel great about your new look.
If you would like to find out more about transgender hair transplants, you can find some additional information in the answers to these frequently asked questions:
Depending on the results you are hoping to achieve, there are several ways to fix a messed up hairline and feminise it in the process. You can have a hairline transplant where you would simply reshape it to appear rounder.
You can add some grafts to lower your hairline for a narrower forehead. Or you can have a larger hair transplant that covers more extensive frontal balding and helps you design a firm, full, feminine hairline.
Yes, it is possible to have insufficient healthy hair follicles for the hair transplant you want. However, should this be the case, your surgeon will let you know about this ahead of time and help you find other acceptable solutions. A good professional will always avoid overharvesting (extracting too many hair follicles from your donor area) so you don’t develop baldness at the donor site.
The amount of scarring you can expect depends on the type of hair restoration surgery you opt for. FUT procedures will often result in a fine, linear scar at the donor area, which can be covered by longer hair but visible with short styles.
However, FUE leaves virtually no scarring, so you can easily have a hair transplant without anyone knowing if you choose to do so.
Normally, your hormone therapy should not affect your hair transplant. You may be especially concerned about taking testosterone after you have had hair restoration for androgenetic alopecia. However, the grafts implanted in your balding spots were harvested from parts of your head where the hair follicles are not sensitive to DHT.
Since androgenetic alopecia occurs when your body converts too much of your testosterone into DHT, your grafts should be safe and remain in place regardless of the testosterone you are taking.
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