MTF Hair Loss: Causes and Treatment Options - Jae Pak MD Medical

MTF Hair Loss: Causes and Treatment Options

Everyone wants their transition experience to be smooth sailing from start to finish, but this isn’t always the case. While medicine has advanced and the transgender community has expanded, there are still obstacles that transitioning individuals must confront as they navigate the path.

For MTF patients, hair loss is one of the top concerns from an aesthetic standpoint. Making the shift toward a new gender identity often involves altering one’s appearance to be more feminine, which may include new hairstyles, among other priorities.

But as MTF patients progress in their journeys, maintaining a full head of hair isn’t a given. These individuals may find that hair is more difficult to keep as they age, and other factors come into play as hormone levels are manipulated along the way.

In this article, we set out to explore the many potential causes for MTF hair loss and discover the degree to which they are within our control. With a better understanding of root causes, we can also offer a range of treatment options that fit with the broader goals of a person transitioning and hopefully provide a meaningful road map for those who need it most.

Hair loss is something that many people deal with, but there are ways to address it as an MTF individual. We’ve seen it all, and we’re here to help. Let’s get started.

What Causes MTF Hair Loss?

It’s impossible to pinpoint an exact cause of hair loss in MTF patients since the sample size is still rather small, and there’s limited data to work with. However, our gathered evidence, both scientific and anecdotal, tells us that MTF hair loss causes fall into one of the three following categories: 


There’s no running from the fact that genetics is the main driver of our appearance and physiology as a whole. Traits are inherited from our ancestors via DNA encoding and express themselves accordingly throughout our lives. 

For MTF patients, the same principles apply, meaning that androgenetic alopecia (standard pattern balding) is inevitable for a certain portion of the population.

The mechanisms at work are largely the same in MTF patients, namely the action of DHT — a testosterone byproduct — interfering with the growth life cycles of follicle groupings on the scalp.

If an MTF person is destined for androgenetic alopecia at birth, the process of transitioning will not move mountains in terms of stopping or reversing this trend. 

We’ll soon discover that genetics can be overcome through planning and execution, but it’s important to remember that everyone must operate within this framework from the outset.


We can’t ignore the influence of environmental factors in any assessment of hair health, thinning, and long-term loss. This goes for men and women of all ages and backgrounds, including MTF patients in the midst of transitioning.

It’s not just air quality, temperature, and other elements that can limit hair growth or cause hair loss, but also a person’s diet, lifestyle, the products they use, and medicines they take separately from their hormone protocols.

Because there are so many variables here – not to mention the genetic blueprint at the core – doctors have a hard time pinpointing the exact environmental factors that cause hair loss. However, trends show that MTF patients can make some adjustments in their favor for hair preservation, which we’ll address later on.

Hormone Therapy

The X-factor for MTF hair loss is hormone therapy, which represents somewhat of a grey area in hair restoration research. 

It’s presumed that feminizing hormones do not directly cause hair loss in MTF patients, but there are no guarantees that reduced testosterone levels will keep hair in pristine condition for years to come.

Also, consider the fact that women of all backgrounds also experience some degree of hair loss in their lifetime — it’s not just a male phenomenon. With this in mind, we urge MTF patients not to alter their recommended hormone treatments to achieve strict hair restoration goals since these outcomes are unpredictable.

When it comes to the transitioning journey, prioritize your health first and address hair loss as a separate component to be dealt with along the way. Your well-being matters most of all.

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Schedule a consultation with Dr. Jae Pak.

What Are MTF Hair Loss Treatment Options?

The causes of MTF hair loss may not be as precise as we want, but there are plenty of reasons to be optimistic about your efforts to achieve the hair you want moving forward. Even if you’re starting to experience hair loss, the following treatment options are on the table, with plenty of satisfied patients speaking to their efficacy.

Styling and Hairpieces

Before making major adjustments to lifestyle and introducing new therapeutics, MTF individuals should start by learning to work with the hair they currently have.

This may not be what you want to hear in your efforts to achieve follicle perfection, but it’s a powerful mindset shift that can pay dividends in the long run when transitioning.

Getting comfortable styling your hair in shorter arrangements or using hairpieces to supplement existing hair is more common than you might think. Full-on wigs aren’t even required — extensions and other options can look great as you discover your personal style.

Natural Remedies

We touched on the influence of environmental factors earlier, and this treatment category should be considered the natural way to counteract those trends.

Specifically, we’re talking about lifestyle improvements across the board, ranging from diet and exercise to trying essential oils or supplements and minimizing stress. 

These recommendations are for everyone in their efforts to combat hair loss, but for MTF patients, in particular, it’s even more fitting to make these positive lifestyle upgrades as you embrace your true identity.

Hair Growth Therapies

We start examining treatments geared directly towards hair preservation and restoration for MTF individuals in this category. You may be familiar with methods like microchanneling, low-level infrared light therapy, and others — these are all legitimate and can work wonders.

Next-generation therapies also include stem cell or plasma injections that have shown promising results so far, although these are more expensive and harder to come by.

If these types of therapies fit in with your lifestyle and budget, by all means, take the time to research and try them out for yourself.


Finasteride is an oral medication that aims to counteract the influence of DHT on the scalp. The medication may be used as a component of hormone replacement therapy for MTF individuals in conjunction with estrogenic compounds. 

However, some hormone replacement experts warn against some of the mental and emotional side effects associated with Finasteride, which may not be advised for transitioning individuals in the early stages of the process.

Keep in mind that oral finasteride can only be helpful with existing hair but not with already lost hair. No matter where you’re at in terms of hair loss and overall health, it’s always recommended that you take Finasteride with professional supervision and follow instructions to the letter.

Surgical Procedures

Our suggestions have been non-invasive and relatively low risk, but many MTF patients choose the surgical route to achieve more drastic and permanent results in a shorter time frame.

The field of hair restoration surgery has made significant leaps in recent years, including the widespread adoption of FUE and FUT hair transplantation, forehead lowering, and other methods.

The question that MTF individuals must ask before pursuing one of these surgical options is how best to achieve their desired look, and what it will take. Hair transplants are highly customized per patient, and the most satisfied clients go into the process with a clear vision in mind rather than a vague idea.

Keep in mind that surgeries such as hair transplantation are not immediate fixes, nor are they always affordable. Expect to spend upwards of $10,000 for a top-tier surgery and spend several months to a year before full recovery and complete results.

Of course, transplantation or forehead reduction procedures can be transformative for MTF patients and revolutionize their appearance, making it worthwhile for those willing to take that step.

MTF Hair Loss Guidance

There is no shortage of options for hair restoration as an MTF person in today’s world. But regardless of what your goals may be, we always urge our transgender patients to follow these guidelines as they seek out new hair solutions.

Work Closely with Hair Experts

With the complex matrix of medications and hormones at play, always keep your doctors fully informed when navigating any sort of hair loss protocol as an MTF person. This is a matter of safety for yourself and future transgender patients who will follow in your footsteps. When in doubt, over-communicate with doctors and those you trust. 

Here at Jae Pak MD Medical, our staff is committed to the patient experience and will be ready and willing to work with you every step of the way.

Document and Monitor Changes

For your own well-being and mental health, closely track your hair progress and stay on top of any changes that may take place. This will ensure you stay firmly oriented and focused on solutions moving forward, no matter what happens.

Team Up With Hair Loss Experts

MTF patients are likely already working with various specialists like endocrinologists, therapists, and HRT doctors. Therefore it makes sense to add a hair restoration professional to the roster to support your hair goals.

These specialized physicians will give honest assessments and helpful guidance in getting the hair you want at any stage of your journey. The best hair loss pros have experience with trans patients and will create custom programs that account for everything discussed in this article.

Transition and Keep Your Hair

There is a lot to look forward to as an MTF individual, including the hair that completes your ideal look. Keep this guide on hand as you take steps toward your goals and consider teaming up with a trusted hair loss expert, like Dr. Jae Pak, M.D., to help guide the way.


Hormonal Effects on Hair Follicles | PMC

Cause of Androgenic Alopecia: Crux of the Matter | PMC

Feminizing Hormone Therapy | Mayo Clinic

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