Trans and starting testosterone? It doesn't have to mean losing your hair

This story was originally published on Them.Getting ready to start testosterone can be an exciting time in any transmasculine person’s life. That said, like literally any medication, HRT can sometimes come with unintended side effects. Feeling pre-T anxiety, including around hair loss, is common for transmasculine people and trans men starting testosterone-based hormone replacement therapy (HRT). Many who are considering starting testosterone-based HRT will post online about their concerns, often attributing their main hesitation for scheduling an endocrinology appointment at their local LGBTQ+ health clinic to their fear of losing hair. This inevitably sparks discourse about working through internalized beauty standards about hair, age, and transness, but that is a topic for another day. If you’re considering starting T and worried about your hair, this is the guide for you.Androgenic alopecia, the medical term for baldness triggered by a genetic predisposition to androgen sensitivity in the hair follicles that shrinks them over time, impacts 80% of cisgender men by the age of 70. When transmasculine people start testosterone-based HRT, it can trigger this kind of hair thinning and loss over time for some people. According to a 2021 study in The Journal of Pediatric Dermatology, 33% of trans people on testosterone-based HRT experience some level of androgenic hair thinning or loss, though it is important to note that research on HRT-related baldness is limited. Though the exact cause of balding can vary from person to person, this largely occurs due to genetic predisposition to high levels of dihydrotestosterone (DHT), which can cause hair follicles to become lighter and smaller over time. It’s important to note that many trans men experience little to no change in their hairline when they start HRT. Also, let’s be clear: balding and hair loss are not inherently negative effects of HRT. For many transmasc people, a changing hairline can help us feel more co