Androgenetic Alopecia in Transgender and Gender Diverse Populations: A Review of Therapeutics

The document reviews treatments for Androgenetic Alopecia (AGA) in transgender and gender-diverse patients. First-line treatments include topical minoxidil 5%, finasteride 1 mg, low-level laser light therapy, and for transfeminine patients, spironolactone 200 mg. Second-line options include oral minoxidil (1.25 mg for transfeminine and 2.5 mg for transmasculine patients), topical finasteride 0.25% alone or with minoxidil 2%, oral dutasteride 0.5 mg, platelet-rich plasma, or hair restoration procedures. Treatment progress should be assessed after 6-12 months using non-sex-based scales like the Basic and Specific Classification or the Bouhanna scales. Dermatologists should coordinate with the patient's primary gender-affirming clinician(s) to ensure shared knowledge of all medications.