Hair Transplantation During Transition

For trans women, hair transplantation can be used to correct a masculine receding hairline or treat androgenetic alopecia.

Indications

For trans women, hair transplantation can be used to correct a masculine receding hairline or treat androgenetic alopecia. For trans men, it is sometimes used for beard hair transplantation.

Techniques

The two main techniques are FUT (follicular unit transplantation, in which a strip of skin is removed from the back of the head) and FUE (follicular unit extraction, in which individual hair follicles are removed). Both techniques move hair from a donor area — usually the back of the head — to the recipient area.

Combination with medication

The results of hair transplantation improve when ongoing hair loss is slowed with medication (for example, finasteride). In the Netherlands, the procedure is rarely covered by basic health insurance.

What to expect

Transplanted hairs usually fall out during the first few weeks and then grow back. The final result cannot be assessed until nine to twelve months after the procedure. The amount of donor hair is limited, so advanced baldness cannot be fully covered and multiple treatments may sometimes be necessary. Risks include scarring in the donor area, an unnatural hairline and temporary shedding of existing hair around the treated area.

Lowering the hairline

An alternative is surgery in which the surgeon moves the hairline forward and reduces the size of the forehead. This procedure is often combined with other facial surgeries and produces immediate results, but leaves a scar along the hairline and only partially corrects a receding hairline. Some women therefore choose both procedures: surgery first, followed later by transplantation in the receding areas. See facial surgeries.

Hormones and hair

Oestrogen and testosterone blockers such as cyproterone acetate stop hair loss in most transgender women, but rarely restore lost hair. The earlier treatment begins, the more hair can be preserved. A transplant is a cosmetic procedure that usually has to be paid for out of pocket in the Netherlands; costs can run into thousands of euros. See oestrogen and health insurance and gender-affirming care.