Male-to-Female Transsexuals and Hair Loss

I am very happy to have found your website which clearly has much to offer for people trying to tackle hair loss. I am writing to you because my question about male pattern baldness is rather specific and perhaps more unusual in your pile of e-mails. Also, I want to obtain further expert advice.

I am a 25-year-old transgender identified person. I noticed some signs of hair loss when I was seventeen, as such, I believe that I started to go bald earlier than many men. I have been on Propecia for nearly ten years now and I have been able to keep my hair, probably because of the drug. A dermatologist examined my scalp and confirmed that I am a male pattern baldness patient (receding hairline is the only presentation at this time). He suggested I continue to take finasteride to prevent further loss of hair.

I have been thinking about a hair transplant to fix my hairline. My hair loss is still not visible without close examination, so I think I will wait and see what the situation is like a couple of years from now.

Because of my transgender identification I am looking into the possibility of receiving hormone treatments (feminising hormones and anti-androgens) and perhaps sex reassignment surgery. Do you think this treatment will have an impact on scalp hair growth? I am told many male-to-female transitioners stop losing hair along with hormone reassignment therapy. Also, please comment on your experience with creating female hairlines.

I realise that you receive a lot of questions from people, and I believe your blog is a very helpful forum for discussing hair loss. I greatly admire you for all you do to help people combating hair loss. I never thought I would respect hair loss professionals as much as I do now.

Male-to-female transsexuals who have hormone reassignment may slow down the hair loss. The chemical castration that is obtained with antiandrogens should augment your present Propecia (finasteride 1mg) intake and it may be effective enough to eventually stop Propecia altogether.

I have done hair transplants for many male-to-female transsexuals with good results and it is a reasonable solution to the receding male hairline. Creating a female hairline can be easily done with a good hair transplant when and if you find it appropriate and timely for your life’s agenda. The creation of a female hairline is common in my practice as I repair many plastic surgery disasters that have wiped out the hairlines in women (complications of traditional brow lifts).