Abstract
BackgroundAlthough many studies report on the suppressing effects of estrogen therapy on facial and body hair in transgender and nonbinary (TGNB) individuals, few studies have elucidated its effects on hairline stability on the scalp. In this work, we assessed the influence of estrogen therapy on forehead length. MethodsAll TGNB patients assigned male at birth (AMAB) seeking facial feminization surgery aged 30 years or older were included in the study. Central and forehead length were collected at initial consultation visits. Variables that potentially influence hair growth were collected by chart review, including age, duration of hormone replacement therapy (HRT), presence of spironolactone, and presence of other hair treatments, including finasteride, dutasteride, or minoxidil. Multivariable linear regressions were constructed with relevant predictor variables, while also incorporating global health scores as a proxy for psychological effects on hair loss. Results171 patients were included in this study, with a median age of 36.0 [interquartile range (IQR): 32.0-46.0] years and a median HRT duration of 2.0 [1.0-6.0] years. Multivariable linear regressions revealed no significant predictors for central forehead length. On the other hand, lateral forehead length was positively predicted by age (B=0.06, 95% confidence interval (CI) [0.03-0.08], p<0.001) and hair treatment (B=0.66, 95%CI [0.14-1.18], p=0.01), but negatively predicted by HRT duration (B=-0.07, 95%CI [-0.10- -0.04], p<0.001). ConclusionsAlthough older age is a predictor of lateral hairline recession in TGNB AMAB individuals, lateral forehead length was also predicted to decrease by 0.07cm with each year of feminizing hormone therapy in patients over 30 years of age.
Published Version
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