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Hair loss and trans women

My general recommendations:

Best online resource is the best site in my opinion for those dealing with hair loss. They have a good forum, too, though sometimes unproven products get breathless testimonials that are unscientific and premature.

Mild to moderate thinning or recession

Look into an oral androgen blocker and topical minoxidil first. For some, this might be enough.

Some thinning or balding at the crown or frontal recession

You might benefit from hair transplants, but it's vital to go to someone really good and experienced! There are a lot of inept people performing hair transplants (believe me, I went to one and had to have them removed later).

Significant recession

At a certain point, hair transplant will probably not be a satisfactory option. You might be better off getting a scalp advancement, a scalp reduction, or both. This can even be done prior to transplants.

If surgery is not an option

See hair systems below.

Thinning and recession

Brooklynne's tips while growing hair out

Hello my name is brooklynne and I found your site when I myself started to transition... One of the big things that I was concerned with when i started to transition was I wanted to have long feminine hair, the problem was my hair grow really slow and is only about 3-5 inches long, Then it accured to me that my friend get her hair braided with extensions added to the end of the braids this is fairly cheap (about $160 - $200) and makes a big difference when transition or at least for me it helped. My confidence was higher and I passed ten times more often I just thought i would offer my suggestion.

Denise's tips

The section on hair at your site is a little "thin," so for those of us without enough to have it medically corrected I thought I may (or may not) have something to contribute. I wear a human hair wig that I altered to be attached semi-permanently, it stays on 24/7 and is undetectable (it can also be made to be removed and reattached at will). I go jet-skiing and water skiing with no problems, it can cost $2000 or more to get this from a salon and about $150 a month for maintenance, I spend about $700 a year and do it myself (longer hair costs more and mine is about 20 inches), besides I still need two more facial surgeries.

This can be time consuming but once it's done, it's done!! Time or money? Hmmm!

Here is what you need to do: First, consult a professional about what style, length and color suit the shape of your face and is appropriate for your age (important!) nothing screams "read me" like an unsuitable style.

Another reader's experiences

I received the following in December 2005:

top four photos are "after" pictures, lowest photo is a "before" picture of hair loss at crown.


When I started transitioning I was 35 years old with extensive hair loss.

I have been on Proscar (Propecia) for 3 years. Proscar can be prescribed and in some cases be covered by insurance. Propecia is never covered by insurance. Proscar and Propecia are the same product.

I have been using Minoxidil (Rogaine) for 3 years. Use the normal strength generic Minoxidil. The extra strength is a waste of money and Rogaine and Generic Minoxidil are the same thing. Rogain is a brand name and costs more.

After 3 years I had regrown some hair, maybe 15% of it came back. It was wispy and fine. But the most important part was that the hair stopped falling out.

I then went to Hasson & Wong for hair transplants. I received 4,500 hair transplants. That was 2 years ago. It cost $11,000.00 It was worth every penny spent. The people there were honest and not out for money. I know another transperson that Hasson & Wong turned away even though the person was loaded with cash. They were honest with her and said it would be a waste of her money because her hair loss was too far advanced.

Post transplants my hair isn't perfect and Hasson & Wong told me it wouldn't be during the consultation. It is thin/fine and that is genetic from both parents. My mother could use transplants and she is in her mid 50s. Matter of fact my hair is better than my mother's hair.

Post transplants I use Nioxon shampoo & conditioner. I still take Proscar and Minoxidil to protect my investment. It is a lifetime commitment.

I couldn't deal with a lifetime of wigs if avoidable. 11k is a lot of money for me; I only make 39k a year. But I have a 401k and I took money it out of that fund. The penalty for withdrawing this money early was $3,000 dollars. But it was worth it. So technically the hair transplants cost me $14K.

Bad hair can ruin all attempts at a female presentation. Before the transplants without a wig I never ever passed. After the hair transplants I pass with ease. It was frustrating because my features are naturally not masculine. The face shot photo is not for public disclosure. I only include it to make a point about the passing issue and the importance of good hair. My quality of life improved so much after the hair transplants. I suppose it is equivalent to the feelings of many transwomen after FFS.

Hair systems

Sometimes after consulting with a couple of experts, they'll say it's unlikely you'll be able to correct your hair loss surgically. If you can get away with a small hairpiece just in front or on top, it's generally better to use at least some of your own hair.

If a small piece is not an option, get the best custom-fit system you can afford.

Synthetic or human?

Before starting the fun stuff, let's talk about wigs. Synthetic wigs are cheap! both in dollars and quality, a good one will last 4 to 6 weeks if worn around the clock and then start to frizz and mat. You can't curl or color synthetics, and you can't use normal hair care products.

On the other hand, the hair I am wearing now is 5 months old, looks great (even if I do say so myself) and I shower, blow-dry and style it as if it were my own. It's human hair and nothing can duplicate it, I expect it to last another 5 or 6 months with a little maintenance.

Wig construction

There are many types of construction. A"mono" top is a must, there should be a "tape strip" along the front. The "mono" top allows you to part it anywhere you want and appears to have individual hairs "growing" out . It also moves realistically. The "tape strip" is for applying double face tape. Use the tape alone for temporary attachment, or for semi-permanent attachment, you will apply a "bonding" agent to the tape.there are several companies that will make you a custom wig( still saving a lot over salon prices) custom human hair starts at around $500.00 and goes up from there (way up!!) . "Off the shelf" prices start at $300.00.

Attachment methods

For temporary attachment you will need to sew in at least 4 "hair clips" as used for men's toupees, one on each side, at the rear edge of the "ear extensions" and at least
one at each corner of the "nape extension." An extra clip in the middle of the nape is best. Apply double face tape to tape strip and position the wig at the hairline,the correct position is everything, (most people tend to position wigs too low in front which is a dead give a way), then attach the clips by your ears, (if you are wearing a color that is close to your own, leave at least 1/4" of your hair exposed from the temple to your ear,then brush "your hair" back into the wig for an authentic looking hair line). Do the same at the nape ( I wear my hair in a "high" pony tail at work,with my own hair pulled into it, there is no way you can tell it's not all mine!!) I have fallen while water-skiing at over 30 mph using this method of attachment, It works!!

Several things to keep in mind:

For semi-permanent attachment it is best to have a custom hairpiece made, it needs to have a urethane tape strip around the perimeter and you will have to have your hair cut to 1/16th of an inch long just inside your natural hairline, leaving some fringe hair as before, the bonding agent adheres to your hair not your head so it will loosen as your hair grows,every 4 to 6 weeks it will have to be removed by cutting it loose from your hair, the tape is then removed from the tape strip, new tape applied, your hair trimmed and then rebonded, it is possible to do this by yourself but I don't recommend it, the bonding agent is permanent , if you make a mistake your stuck with it, have a professional do it the first time and have a friend who can help watch.

I hope some of this is helpful, I am not a writer (I can't even type). I will be more than happy to answer any questions via E-mail: (Denise)

Some sites to visit (not an endorsement):

Sherry Joanne writes in July 2003:

I don't know whether you would like to link to that, or prefer that I submit something for the project directly. Please let me know. I also have an essay about my Apollo hair replacement system at:

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Transsexual Road Map > Physical > Hair loss and trans women

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This page last updated December 6, 2005