PSA for trans men and trans mascs on T who are afraid of/concerned about or experiencing male pattern baldness: Talk to your endocrinologist who monitors your T about hair loss before you talk to anyone else, you have options!
When the hair in the top of my head started to thin, I talked to my regular GP. She told me it should be fine to use Rogaine topically. There were no other options, either because she was somehow not aware OR was under the impression that alternatives might interfere with HRT. If this was the case, she did not relay this info to me, and if she had, I would have made an early appointment with my endocrinologist, who specialises in HRT for trans people specifically, and asked her about my options.
But, since I only have appointments once a year with my endo now because my levels are generally super consistent, I decided to try Rogaine. I lasted about a month, because it basically meant I had to wear a lined hat at all times to make sure I wasn't getting any on my pillow/cats/child. You need to apply it two to three times a day and leave it on your scalp for a couple of hours for the best results, every day, forever, and if you stop using it, your hair goes back to whatever it was up to before that made you concerned in the first place. I quit after a month and resigned myself to eventually going bald.
I finally had a phone appointment with my endo last week (was supposed to be in person but she had an emergency and was working remotely for the day), and when I brought this up and that I had tried Rogaine but couldn't deal with all of the above + my scalp was not reacting well to the alcohol in the foam so I quit, she was like ????? what? why didn't your GP just prescribe you finasteride???
I am now on finasteride! It is a dirt cheap, tiny ass pill. I only need to take a quarter of a pill once a day (my endo also helpfully explained to me that pill cutters exist and are also dirt cheap, so perfectly cutting a pill into quarters takes about 5 seconds and I got it for a whopping $8). Just like Rogaine, I WILL need to take it every day, forever, but it's not going to get all over my pillow and make my cats sick or cause my kid to grow a beard or whatever. It isn't going to dry my scalp out, and it also the cost comparison is a joke. I take it every morning at the same time I take my adhd meds, so it's easy to remember.
I have seen so, so many trans men and mascs online lately worried about this, probably because I've seen so many conservatives and the kind of detrans people that conservatives like to parade around put a lot of emphasis about how T will make you UGLY and make all of your hair fall out. I do feel sorry for any detrans women who are dealing with wonky hairlines or male pattern baldness, but also it sure is convenient that none of them see fit to mention that if you are experiencing those things, you can literally just talk to your endocrinologist about what your options are and then take a quarter of a pill every day to fix it. Almost like making you aware of that might move you away from their end goal, which is getting you to detransition.
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The drug finasteride, already used to treat hair loss and enlarged prostates, could also help to cut the risk of heart disease.
In an analysis of data from both male humans and mice, the drug was shown to improve health and reduce levels of cholesterol.
Too much cholesterol in the body is well known to increase heart disease risk, as it encourages atherosclerosis: fatty deposits in blood vessels, blocking the flow of blood through the arteries. Eventually, that can lead to strokes or heart attacks.
Continue Reading.
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I’m tempted to go on T, but there’s one thing thats really setting me back. Both my father and his father went bald very early on in life (starting around senior year of high school). I’m absolutely terrified that I’m going to start balding if I begin taking testosterone
Finasteride will help mitigate hair loss. You can also bring up your concerns with your doctor, and they can discuss best prevention methods with you. There are lots of options (hair loss is a common dysphoria trigger for many cis men), and you can see some of the different treatments people have chosen from this reddit thread.
You can also go for a low-dose of T. It won't stop hair loss, but it will let you take a slower journey through your transition to explore if testosterone is right for you. Do know not all effects of T are reversible, though, including hair loss. But a low dose could give you time to see how being on T makes you feel, and if it's something you feel is worth pursuing even though your fears of hair loss. And if you notice the beginning of hair loss and hate it, you can stop taking T and prevent further loss from occurring.
Finally...it's hair. Hair is one of the most dynamic/least static things on our bodies. Hair loss happens. Hair thinning happens. Hair color changes happen. If you really hate it, then you might find salvation in wigs. But you might also find being bald empowering. There's nothing wrong with baldness! Especially if you're able to just own that and rock it. I think it's worth exploring...what about balding triggers fear for you? What's the underlying fear you're struggling with?
But also - you don't have to have the answers now. It's fine to take as much time as you need to consider this, weigh the pros and cons, and make your decision. It's also completely fine to make one decision now and change your mind later. Spend some time on other transition aspects that may feel more approachable right now. Those might be social, fashion, surgery oriented or anything else. See what kind of happiness you can find without T. It might help you make your decision later down the road.
It's okay. You're not alone. <3
~Mod Pluto
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Hey Trans Folks--Important Finasteride Fact
Finasteride causes temporary hair loss, known as Finasteride shedding, that starts roughly 2 weeks-2 months in to beginning treatment.
My doctor did not mention this to me, so I googled it in a panic yesterday after running my fingers through my hair had me pulling away 20-30 hairs at a time.
So if you started taking Finasteride to counteract hair loss or encourage new hair growth, please don't panic and think it's not working!
Hair regrowth is a long, slow process, and you won't start to see new grown until the 3-6 month window, with full results showing up after a year.
This site focuses on cis men, but does offer good information about Finasteride treatment and hair shedding.
Also if you didn't know about Finasteride and are experiencing hair loss on testosterone, or experienced hair loss before starting estrogen/spiro (and spirolactane isn't helping you on that front), talk to your care team about finasteride.
Finasteride blocks testosterone from turning into DHT and has shown to stop hair loss and encourage new hair growth.
(On the down side, DHT is what encourages bottom growth, vocal changes, and facial hair growth if you're on T, so be aware of that and do your research. I am still getting facial hair growth and vocal changes personally, just slower and with fewer "cracks" in my voice.)
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Dear afabs going on T,
Your hairline is going to change (if you're a teen, it might be a while yet). Your hair itself will change. Your hair will not look the way it does now.
There's a very good chance that your hair will thin, your hairline will recede, and/or you will bald.
This is not am ambiguous "maybe someday" thing, this is a "it started for me when I was 23 and i'm 27 and panicking and I want you to start coping now" thing.
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