Hair Loss Among Transgender and Gender-Nonbinary Patients: A Cross-Sectional Study

In a cross-sectional study conducted in fall 2018, researchers investigated the frequency of scalp hair loss among transgender and gender-nonbinary individuals and its relation to gender-affirming hormone therapy. The study, which had 991 respondents with a 77% completion rate, found that 65% of transwomen, 43% of transmen, and 35% of nonbinary people reported experiencing scalp hair loss or thinning. Notably, transmen on masculinizing hormone therapy (MHT) reported a significant increase in the frequency of hair loss compared to those not on MHT (45% vs. 17%, p = .0019). Transwomen on feminizing hormone therapy (FHT) did not show a significant difference in the frequency of hair loss compared to those not on FHT, but those on FHT reported less severe hair loss. The study concluded that testosterone use in gender minority patients is associated with worse patient-reported androgenetic alopecia (AGA) severity scores, while feminizing hormones may help stabilize hair loss in transwomen. However, the study had limitations, including the lack of a cisgender control group and potential response bias due to the convenience sample from social media.