For many transgender and gender diverse individuals, hair removal is a critical component of gender affirming care. Whether for facial hair reduction or surgical prep for procedures like vulvovaginoplasty or phalloplasty, understanding the options and limitations of hair removal is essential for guiding your patients.

Laser hair removal is a popular option, but the type of laser matters—especially for patients with darker skin. An Nd:YAG laser is recommended for patients with highly melanated skin to avoid complications like post-inflammatory hyperpigmentation. Meanwhile, an alexandrite laser works well for lighter skin tones.

Electrolysis is another option, especially for pre-surgical hair removal that works on all skin  and hair colors. IPL or intermittent pulse light is not recommended for surgical preparation. 

In general, hair removal prior to gender affirming genital surgeries take about a year.

It’s crucial to prepare patients for the time, discomfort, and cost involved. Some may qualify for insurance coverage, but others will need to pay out of pocket. Clear communication about the process will help patients achieve their goals without unexpected delays.