Experience with hair loss as a transgender male

[benmightbebalding]

Hi!

One of the major reasons I wanted to post here is because I wasn't able to find any posts related to transgender female to male individuals. I'm not sure if that's because balding is a potential side effect of transitioning that people want to ignore, as it's seen as a negative one, or what, but I figure if I post, there will at least be one thread trans guys can relate to. My other reason is to have somewhere to post updates the further I get into my treatment.

That being said, I'm not 100% sure what my balding status is. Like with any male puberty, I noticed my hairline receded into what at first I considered a "mature hairline". Even at that point, I was paranoid that it was receding more than normal, as I'd lived with a female patterned hairline for nearly 25 years. After a year on testosterone is when I really started worrying that I might actually be balding. It was almost like I could tell which parts of my hairline were going to recede next, and they would. Obviously my testosterone is supplemented, so I'm able to adjust my dose. Thinking maybe my dose was too high and that was making it worse, I had the dose decreased back in April, when I was around 1.5 years into my transition. I had my levels checked just prior to that and later found out my freeT was around 150, and total was in the 500 range. As far as I know, that's pretty normal. Four months later and that hasn't made a difference. I still feel like I'm balding at the same rate. My doctor prescribed me finasteride 1 mg, and I've been taking it for the last 5 days. I'm hoping I'll see a difference, but part of me is worried that I'm not actually balding and this is all driven by my anxiety, and I'm just going to make my hair worse.

As far as genetics go, my dad is just about bald on top, but this is something that has happened within the last 10 years. He's in his late 60's. No other men on either side of my family had any issues with hair loss. My older brother has a similar hairline to mine.

These two pictures are pre-transition



These are around 1 year


These were taken the other day--around 2 years


One thing that concerns me is how the line of my sideburn has changed. As you can see in the most recent pictures, on both sides my hairline is completely aligned with how my sideburn grows. It used to slope forward like most male hairlines do. Is this a definite sign of a receding hairline, even if it the temple doesn't recede past the line of my sideburn? I have a more direct comparison of how it's changed in the last 6 months (how rapid it's changed is what's so alarming to me), but I might need to post that in an additional post.

If my hairline were to stay where it's at right now, I'd be perfectly fine. What bothers me so much is feeling like being bald is in my very near future. I feel like I can't even enjoy having presently because I'm so occupied with thoughts of going bald. Hopefully the finasteride will help, though I know it's going to take a considerable amount of time to see any progress. If anyone suggests I should also be using minoxidil, I'd appreciate if you let me know!

Thanks for reading if you have! :turned:

 

[benmightbebalding]

Here's the sideburn comparison I was talking about.

I know in the first picture, the sideburn is clearly sculpted, but I still think the difference is obvious.

 

[benmightbebalding]

I've heard of cases like this. Well, I guess when you decide to make this kind of transition, you should also be ready to welcome common conditions that affect men.

Oh yeah. I knew that medically transitioning would come with a number of unwanted side effects, male pattern baldness being one of them. I was hoping I would be lucky and not have to deal with it, but.. no such luck. I told myself beforehand that it wouldn't matter to me, because transitioning would be saving my life (and it has), but I've found out that's easier to think before you've started experiencing it. More trans guys than not don't seem to have to deal with it, so it's a little frustrating, but I guess it really is a crap shoot.

Anyway, thanks for responding!

 

[shyyguy123]

You've got a great hairline right now (for a guy). Like you said you're probably a little overly paranoid because you lived so many years with a female hairline.

You should be good for years with finasteride. Keep in mind that in studies it completely halted hair loss in 85-90% of guys.

You've got great hair AND you're on finasteride, I would stop worrying about it for now. Obviously just keep an eye on it over the years. I wouldn't add min or anything, there's no need.

 

[Cue Bald]

If you were a "born" male, I would say mature hairline no male pattern baldness. probably the new T/DHT in your body has given you a mature hairline e.g. a female / preteen male NW1 to a normal adult male NW1.5.
My advice would be not to take finasteride for 6 months, take a photo in 6 months; if it has gotten worse then get on finasteride, if it hasn't gotten worse, don't worry about it, you probably have a mature hairline only. (Mind if I were in your shoes I would take finasteride anyway as I wouldn't want the chance I'd lose some hair )
finasteride can also stop new body hair / facial hair from coming in BTW, but looking at your pictures I think you have decent growth anyway so that shouldn't be a problem (unless you want more?)

 

[benmightbebalding]

Thanks to everyone who replied to my initial post. The replies made me feel a lot better.


I did end up starting finasteride, which made me feel like I'm at least doing something about the fact that I may be balding. Since I know it can take months for the drug to show any results (if it does), I tried to stay away from the forums so I wouldn't be more tempted to obsess over my hair. But at this point I'm nearing 3 months, so I felt like posting an update for my own records. I (obviously) have not noticed any positive results yet. I think I've experienced shedding, but I'm not exactly sure I understand what that means. All I know is that my hairline has either continued to change in the way I've worried it's going to, or I have a very powerful imagination. Also, it seems to be thinning diffusely, especially on the sides. Weirdly, my facial hair has made considerable progress (Cue Bald, to answer your question.. Ideally I'd be able to grow a nice beard, but I'm content with what I've got now, and ultimately I'd rather have hair on my head).

Here are some pictures:

Dry, in regular light.

Back, somewhat harsh lighting

Wet, direct light