Androgenetic alopecia (AGA), or pattern hair loss, can be a significant concern for transgender and gender diverse patients, especially those on testosterone therapy. While genetics play a major role, hormone therapy can accelerate hair loss in some patients, making early intervention critical.

Topical or oral minoxidil is typically the first-line treatment for AGA. Oral minoxidil is often more convenient and better tolerated, but patients need to understand that the effects aren’t permanent—once they stop, the hair loss resumes. Finasteride or dutasteride can be added for more aggressive treatment, and spironolactone may be helpful for patients on estrogen.

It’s important to remember that hair loss isn’t just about appearance—it's tied to gender affirmation for many TGD individuals. Early treatment improves outcomes, so have honest conversations with your patients about their goals and how best to achieve them. Learn more by joining QueerCME- Dr. Gunnell, a dermatologist, deep-dived all of this content!