Hair transplants to improve the gender specific appearance of patients, mainly male to female but also male to female gender reassignment.
Male to Female Transgender
Male pattern hair loss is obviously a distinctive pattern, normally a male chracteristic. If you see someone with this type of hair loss, the cosmetic appearance suggests a masculine look. This is true of women (see the female hair loss page) or of male to female transgender patients.
Most clearly seen is temple thinning and recession. This can be difficult to hide, especially from the side or in windy, rainy conditions and hair thickeners such as Nanogen don’t really help.
Whereas, crown thinning can be helped by hair camouflagers, hairstyles, hats or even small hairpieces. And it simply isn’t as visible as temple recession.
Hair transplants are probably best for the temple areas, although scalp advancement techniques can be useful, especially if a forehead lift is desired as well.
Most transgender patients are also taking medication – typically oestrogens but also antiandrogens such as cyproterone acetate. However, although many patients and doctors believe this is sufficient to stop further male pattern hair loss, in fact this isn’t necessarily true. Hormones have a complex dynamic and testosterone, oestrogen and dihydrotestosterone (DHT) are closely related and it is the DHT that crucially cause the male pattern balding. So even though less testosterone may be produced, it is still possible to produce sufficient DHT to cause further MPB and blocking the DHT (by Finasteride, Propecia, Avodart) is still needed. It may help even produce some regrowth.
Female to Male Transgender
Often, simply taking testosterone is sufficient to initiate male characteristics such as beard growth, change in fat deposition, muscle growth and male pattern hair loss.
Women still carry the genetics for MPB even if they do not demonstrate the hair loss. This is because there is a threshold level of testosterone/DHT required which most women do notproduce enough of (see female hair loss page).
However, if extra androgens are administered, then this level will be reached, which can be seen in some female athletes who illegally”dope” and in female to male transgender patients. If such patients do not want MPB, then Finasteride could be used although it is worth pointing out that DHT is a potent androgen in its’ own right.