Hair transplant surgery and gender affirmation: Ask an expert

People within the transgender community may experience gender dysphoria as a result of hair growth patterns which are not in keeping with their gender expression. Hair transplant procedures which reshape the hairline or create a fuller head of hair can be a useful tool in achieving a look that is more in keeping with a person’s affirmed gender. In this article, leading hair restoration surgeon Dr Greg Williams details how hair transplant procedures can support transgender people in their transition.

How can hair transplant surgery help transgender people in their transition?

For those in the transgender community, there are two hair transplant surgery techniques which are commonly used; follicular unit extension (FUE) and strip follicular unit transplantation (FUT). In the FUE process, groups of hair follicles are extracted individually and are later inserted into the chosen area. In the FUT technique, however, a strip of skin is removed from the donor site, including the hairs and follicle groups. This is then dissected in order to separate each individual hair follicle group into grafts which are later transplanted into the recipient area. These procedures can help to restore a fuller looking head of hair and can also be used to adjust the hairline to a more feminine-looking alignment.

How does the transitioning process affect hair growth?

For those undergoing MtF (male to female) affirmation, changes in oestrogen levels can negate the effect of dihydrotestosterone (DHT) on the hair, meaning that the onset or development of male pattern hair loss (MPHL) is halted. For many people, this will mean avoiding the development of a receding hair line and thinning in areas of the scalp. However, if signs of male pattern hair loss are already evident before the transition process has begun, this may leave the patient with an undesirable hairline, usually in the shape of an ‘m’ or thinness. Hair transplant procedures can adjust hairlines to form a more curved, feminine shape as well as a fuller head of hair.

The use of male hormones in a FtM (female to male) transition affects a person’s appearance in various ways. This also includes the hair and over time, it is also possible that MPHL will occur. Hair loss occurs when the male hormone DHT stimulates hormone receptors in the roots of the hair. There is no way to prevent MPHL but some medications, such as Minoxidil (known under the names Regaine or Rogaine) and Finasteride (also called Propecia or Proscar) have been proven to show a reduction in hair loss in the long term. A hair transplant, however, may offer a more reliable and permanent solution to hair loss. Hair transplantation can also be used to create facial hair, a beard or eyebrows as desired by the patient.

If you are considering a hair transplant procedure, don’t hesitate to visit Dr Williams’ Top Doctors profile to book a consultation to discuss your options.