Transgender Male-to-Female Taking Dutasteride

Hi Dr. Rassman,

I am a genetically born male, who just turned 23 years old. I am a transgendered and just recently began taking hormones 2 months ago to transition into a woman.

At age 21, as a male, I noticed my hair thinning in the temple regions. My mother father began balding pretty heavily in his 20’s. I knew I was transgendered but was unable to afford transitioning and beginning hormones at that age so I went to two dermatologists and was prescribed Propecia both times. I was on it for a little over a year. Surprisingly after a year I seemed to have less hair in the temple region and front hairline region. I can’t say it didn’t work because who would have known if I would have lost that hair anyways and Propecia helped me loose less? I’m not sure. My hair is definitely thinner and some family noticed but it’s not “socially” noticeable.

Two months ago I stopped taking Propecia I began a female hormone regimen to transition into a female begin that I am transgendered. I take 6mg of Estrace as well as Avodart daily. I also get a monthly injection of Depot Lupron 7.5mg used to treat advance prostate cancer in men and is similar to a “chemical castration”. So needless to say my testosterone levels will be taken WAY down and hopefully Avodart will absorb the leftover DHT in my system. However, at this point, now living as a female with female hairstyles I still have an issue because my hairline has started to mature in a masculine look and it’s very thin in the temples and at my hairline.

With my situation, and based on the medication’s I am taking – should I expect more hair growth than I did on Propecia? Honestly I think I need a forehead reduction but this could be particularly tricky with my thus receed hairline. What are you suggestions, or observations? Should I give it time? I CAN NOT loose ANYMORE hair and I REALLY need regrowth! I haven’t tried Rogaine because I was told in doesn’t work in the temple region on genetic men – but now that I’m on female hormones does that change that?

PLEASE HELP ME DOCTOR!!!!!!

Thank you SOOO much for this wonderful opportunity!

You have chosen non-surgical, hormonal treatments for eliminating your male hormones. Dutasteride, although not yet FDA approved for regular male pattern baldness, is studied and believed to be more potent than Propecia (finasteride) for prevention of male pattern baldness. You are right in that using other anti-androgen medications are also important to slow down the process of your male patterned hair loss. I am not sure whether Rogaine can add anything to the medication regimen that you are currently on. You have to know that it is unlikely that you can grow your receded hair completely back and medical treatment can only prevent further loss and in some cases thicken the miniaturized hair in thinning area.

For treating the receded areas that are not recovered by the maximum hormonal treatments that you are doing and to make a female hairline, the available options include hair transplantation and possible hairline lowering procedures. The latter runs a risk if you should continue to bald from your genetics, while a hair transplant has been successfully used for people like you who have male pattern hairlines and wish to migrate to a feminine hairline. Please consider coming in for a consultation so that a Master Plan will have will be clearly defined for you.