Transgender Focus: Hair Loss and Restoration
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Transgender Focus: Hair Loss and Restoration
Dr. Michael May (FRCS)
Medically reviewed by
Dr. Michael May (FRCS)
Updated on May 7, 2022

The transgender and transsexual journey is an exciting yet challenging time. One of the issues many transgenders continue to be concerned by is hair care and hair loss. In fact, 31% of ISHRS members reported seeing an increase in hair transplants for transgender patients [1].

If male pattern balding runs in the family, many male to female transgenders assume that they will suffer some form of hair loss. On the other hand, female to male transgenders may have difficulty achieving the facial hair consistency they want or an even appearance of a beard.

In this article we are going to explore some some of these concerns more deeply, hear what experienced transgenders have to say about hair loss and discuss what the options are, both surgical and non-invasive.

Male to female transgender hair loss – what are the concerns?

The main concern with hair loss in male to female transgenders is the presence of the male pattern balding gene in the family. Despite transition, the fear remains that genetics will prevail. However, as the experience at Transgender Care suggests:

‘Hair loss (or alopecia) in transgendered women is normally associated with the normal pattern of balding seen in men–the variety of receding hair line and balding patterns prior to the use of female hormones. Baldness in men is not a disease, but rather the body’s reaction to the male hormones (androgens) in genetically predisposed individuals.

However, a smaller but still significant percentage of transgendered women (prior to hormone treatment) suffer from female pattern thinning and balding. This condition isn’t often mentioned. The condition is also more prevalent in genetic women than one may realise since many women use concealing hairstyles, wigs and hair enhancements as a means of concealing the problem. About 15% of genetic women experience some degree of noticeable hair loss.’

We have worked with transgenders from both sides of the spectrum and find that if an eye is kept on the rate of hair loss, it can be addressed gradually and subtly, if needed at all. Not all hair loss results in hair transplant, there are other options.

Hormones and hair loss – what do you need to know?

We are often asked if there is any need to address balding in transgendered women, since the role of hormones such as Hormone replacement therapy is often considered to override the male balding pattern. This is a keen topic however and there are varied experiences. One transgendered woman online explains:

‘Transsexual women in general don’t have to worry about baldness the way males do. Once estrogen rules the system, and testosterone levels are very low, there is very little “raw material” to make DHT out of. DHT (dihydrotestosterone) is what causes follicular miniaturization. Personally, I have found that HRT has greatly improved my hair. I was on (a DHT blocker) for a year before I started HRT, but after only a couple of months on estrogen, I saw improvement in my hair’s texture (a result of the chemical changes in the sebum) and the new growth was coming in softer and finer.’

However, another forum contributor explains:

‘Considering women can go bald too, I would assume even HRT couldn’t stop hair loss if it’s meant to be.’

In our experience, female pattern balding is a growing issue and can be just as present as in males. We always suggest having a consultation with a specialist who can really diagnose the issue and provide definitive advice as to options for hair restoration if it is needed. Surgery may not need to replace products however it needs to be considered that hormones will most definitely play a role in transgender hair appearance and hair loss.

What other hair restoration options are there?

Hair thickeners

There are a range of hair thickeners which can help to reduce the appearance of alopecia areata (diffuse hair loss) occurring over time. These products work through hair thickening fibres which stick to your hair using static electricity creating the appearance of a fuller head of hair.

Hair loss medication


The most popular and widely-used hair restoration product is still Minoxidil 4% and Minoxidil 5%. Minoxidil reactivates and revitalises shrunken hair follicles by increasing their size. With continued applications on the scalp, the follicles gain greater volume so that longer and thicker hairs are produced.


Finasteride is precribed medication in the form of an oral tablet. Finasteride works by decreasing the amount of DHT in your body. Fnasteride works by inhibiting 5alpha-reductase, which stops testosterone from being able to convert into DHT. This results in slowing down the rate of hair loss.

Learn more about finasteride dosage.

Facial hair transplant for female to male transformations

More transgendered males are opting for beard transplants in order to acheive a thicker facial hair. In many cases, natural growth is already present however the look is perhaps unrefined, uneven or patchy. In these cases a beard and even a eyebrow transplant can help make modifications to ones appearance which are undetectable, even under close inspection.

We are here to help

If you are in transition or post transition and have hair loss concerns or an existing hair loss condition, we can help. Over the years we have helped many transgenders achieve a full head of hair or improved the look of natural facial hair. If you would like to know more or would like to book a totally confidential, no-obligation consultation, get in touch with us here

photo credit: CarbonNYC via photopin cc


  1. ISHRS 2020 Practice Census
Dr. Michael May (FRCS)
Medically reviewed by Dr. Michael May (FRCS)Updated on May 7, 2022
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
Talk to a specialist ☎ 020 7935 1861.
Dr. Michael May (FRCS)
Medically reviewed by
Dr. Michael May (FRCS)
Updated on May 7, 2022

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