Transgender Hair Transplants
Transgender hair transplants have become increasingly popular but there is little information about and for trans patients. If there is evidence of genetic pattern hair loss, then medical therapies should be considered to slow future thinning. Many patients have already been placed on a variety of hormonal therapies to support gender transitioning; it is important to also address residual testosterone and dihydrotestosterone (DHT) in the body that can be a source for continued hair loss. For example, spironolactone, minoxidil, and/or finasteride can address hair loss.
After the potential for further thinning has been addressed with a discussion of medical therapy, then surgical planning can begin. Surgical techniques are the same for transgender transplants and standard hair restoration surgery, the aesthetics associated with hairline gender reassignment require the highest level of understanding of the differences in between male and female hairlines.
Male to Female Transgender Patients
Male to female transgender patients often benefit from hair transplant focused on adding density to the front and temples in order to round-out the hairline into a more feminine shape. Creating a voluminous female hairline may require two surgical procedures in order to obtain the desired density, especially if a large area is initially transplanted at the hairline. Furthermore, transplants need to be spaced one year apart because the first transplant will need to grow before planning a potential second procedure to provide additional coverage.
Female to Male Transgender Patients
Patients who are transitioning from female to male may request hair transplantation into the beard area for additional masculinization. Use of grafts for the beard need to be carefully weighed against the possibility of needing these grafts for potential future thinning on the scalp. In patients with a strong tendency towards future genetic thinning, we encourage caution because patients may need this hair to cover thinning at the front and top of the scalp.
Altogether, hair transplants for trans patients is complex but highly rewarding. Through careful medical management and surgical planning, the result is an elegant cosmetic transformation.