Medical experts explain hair transplants and why trans folks are lining up to get them
Hair transplants used to be an embarrassing secret no one talked about, but in recent years, celebrities like Joel McHale and John Cena have opened up about the surgical procedures theyve gotten to combat hair loss. But its not just straight, cis male celebs who worry about hair loss. Trans singer Sasha Allen who you may know as Adore Delanos boyfriend got candid in a recent TikTok video about his fears prior to going on testosterone, and hair loss was on the list. Trans women who began going bald before transitioning, trans men who lose hair after starting T, trans people wanting a more masculine or feminine hair line, and gay men worried about hair loss affecting their attractiveness are all candidates for hair transplant surgery.In fact, according to a 2022 survey by the International Society of Hair Restoration Surgeons, nearly 37% of surgeons reported an increase in the number of transgender hair transplant patients in their practices.So to get the tea on the procedure, whether hair transplants are gender-affirming care, and how to find a good surgeon, we talked to medical experts with years of experience treating hair loss. Is hair transplant surgery a form of gender affirming care?From hormone therapy to bottom surgery to facial feminization or masculinization surgery, there are many options for transforming you outward appearance to match how you feel internally, but few people talk about how hair transplant surgery can play a role. Hair transplants absolutely can fall under gender-affirming care. In fact, for trans patients, this is one of the few procedures that affects both presentation and perception at first glance, Kiara DeWitt, who is the founder and CEO of the progressive, gender-affirming med spa Injectco, tells PRIDE. A receding hairline or sparse growth can undermine the alignment between how someone sees themselves and how they are seen. Hair framing plays a huge role in gender expression, so whether its a feminizing soft hairline or a masculine widows peak, reshaping that frame can make everyday life more livable.Who is a good candidate for hair transplants?The best candidate for hair loss surgery is someone between the ages of 25 and 45 who has realistic expectations of what can and can't be achieved and has caught hair loss early enough to not be too far gone where options are more limited and much more expensive, hair transplant surgeon Dr Mohammed Ditta explains. Hair transplants, which take hair from the back of the head and "transplant" it to balding areas, usually work best on people who have enough healthy hair left, and who are willing to go on hair loss medication either oral or topical to prevent future hair loss. A good candidate is someone with sufficient healthy donor hair typically from the back or sides of the scalp who is experiencing male-pattern or female-pattern baldness and has realistic expectations for the outcome, says Dr. Abraham Armani, an award-winning, board-certified hair restoration surgeon. These criteria apply equally to gay, straight, cisgender, and transgender individuals.Why would trans men and women benefit from hair transplant surgery?Some trans women who lost hair before transitioning worry about not having a feminine enough hairline, while female-to-male trans folks may be concerned about how testosterone will accelerate hair loss, and plenty of gay men would prefer to have a full head of hair. Testosterone therapy in trans men can stimulate facial and body hair growth but may also accelerate male-pattern baldness. Hair transplantation can restore a receding hairline, fill thinning areas, or create a fuller beard, Dr. Armani says. These goals are common for some trans men as well as many cisgender men experiencing hair loss.DeWitt agrees, and says that gay men and trans women also benefit from hair loss surgery, Gay men may pursue the surgery to refine density, correct recession, or enhance styling flexibility. For trans women, restoring hair lost pre-transition can soften the hairline and complement other feminizing treatments. The technique may vary based on goals, e.g., rounded frontal hairlines for trans women versus more angular lines for trans men or cis men.Can testosterone treatments for trans men lead to hair loss?Much like Sasha Allen, many trans men worry that they may suffer from hair loss if male pattern baldness that runs in their family. Genetics plays a big factor, and if the hair loss gene is present, then testosterone therapy can speed it up as it's based on the follicle's sensitivity to DHT (Dihydrotestosterone) as well as the quantity in their system, Dr. Ditta explains.DeWitt says that since testosterone can contribute to male-pattern hair loss in those genetically predisposed, its important to start talking to trans patients early about their options.This process can occur within a few years of starting hormone therapy or develop gradually over a decade. I think it is important to address this possibility early so patients understand their options for preservation and restoration, she cautions.Can hair transplants have a positive impact on self esteem?Hair transplants can not only help people achieve an outward appearance that matches their gender identity, but in an image-obsessed society like the U.S., this type of procedure can boost confidence and reduce feelings of self-consciousness.Physical features often influence self-perception, and hair plays a visible role in that equation, DeWitt says. Seeing a fuller hairline in the mirror can change the way someone engages socially, professionally, or romantically. It can shift attention away from what feels like a flaw and allow personality to take center stage. Self-esteem gains are rarely about the hair itself but about what it represents to the individual.Do people sometimes require revisions or additional surgery if they experience further hair loss after the initial procedure?Unfortunately hair loss surgery doesnt stop future hair loss, which is why surgery is usually combined with hair loss medication like Finasteride. In fact, earlier this year, Community star Joel McHale admitted to having four hair transplant surgeries. It's important that patients understand that hair transplants won't stop future hair loss from happening, Dr. Dittas says. They work via a redistribution of hair from the back and sides of the head (this area is known as the donor area as it's resistant to the hormone DHT that causes hair loss) to the areas of baldness.Dr. Armani warns of the same issue, Hair loss can be progressive, meaning untreated areas may thin over time. Strategic, long-term planning helps ensure the hairline remains balanced and natural as changes occur.Why are people traveling to Turkey for hair transplants?Most travel to Turkey for lower costs, not necessarily higher quality, Dr. Armani explains. While some clinics there are reputable, many operate in high-volume settings that can compromise safety and artistry. Wherever the procedure is performed, thorough research is essential verify credentials, review before-and-after photos, and confirm the surgeon personally performs the critical steps.Dr. Ditta says the devil is in the detail because while there are many good surgeons in Turkey, many of the clinics are high volume where technicians, not surgeons, do most of the work, and the doctors act like a conductor of the orchestra, meaning that he is supervising these procedures and letting the technicians do all the work which is how the procedures are so cheap.What are some of the risks of the procedure?Hair transplant surgery is relatively safe and the risks are low, but patients may experience excessive bleeding, anesthesia complications, folliculitis, infection, swelling, itching, scarring, unnatural hair growth, or poor graft survival. Possible risks include swelling, temporary numbness, infection, or scarring. Rarely, patients may experience suboptimal hair growth or temporary shedding of existing hair, Dr. Armani warns. These risks apply to all patients and are minimized by choosing a board-certified, experienced hair restoration surgeon.How do you find a good surgeon and how much should you expect to pay?If you are thinking about a hair transplant, you need to look for a board-certified hair restoration surgeon with proven experience, documented results, and strong patient reviews, Dr. Armans says. DeWitt says that you should also check out a potential surgeon's before-and-after photos, verify their board certifications, and confirm that the surgeon performs the majority of the procedure themselves. Consultations should include an honest discussion of density expectations, graft counts, and recovery timelines, she explains. As for how much a good surgeon will charge, that depends on the extent of the surgery you want. In the U.S., costs typically range from $8,000 to $20,000, depending on the number of grafts, surgical method, and case complexity. These same standards apply to anyone seeking a natural, lasting result, Dr. Armani says.Sources cited:Dr. Abraham Armani, an award-winning, board-certified hair restoration surgeon.Dr Mohammed Ditta, a hair transplant surgeon.Kiara DeWitt, is an accredited master nurse injector with medical aesthetic certification and the founder and CEO of Injectco, one of Texas top medical aesthetic clinics.
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