Clinical Pearls Addressing Hair Growth and Loss in Transgender Patients on Hormone Replacement Therapy

The document addresses the challenges transgender patients face with hair growth and loss during hormone replacement therapy (HRT), noting dissatisfaction with hair-related outcomes compared to cisgender individuals. For transfeminine patients, estrogen and antiandrogens like spironolactone and finasteride are used but often fall short in reducing facial hair. Transmasculine patients experience increased facial and body hair growth with testosterone but risk androgenetic alopecia. Minoxidil is recommended for hair growth due to its cost-effectiveness and compatibility with HRT. The paper stresses individualized care, considering side effects and alternative options like hair transplants. It also highlights the lack of clear evidence on hair removal methods, high costs of treatments like eflornithine cream, and barriers such as financial obstacles and state-level restrictions on gender-affirming care.