Transgender and gender-diverse individuals (TGD) undergoing gender affirmation with testosterone, or masculinizing hormone therapy (MHT), may experience adverse dermatologic effects, including acne and androgenetic alopecia (AGA).1 In a cross-sectional study2 of 50 transmen receiving MHT for an average of 10 years, most patients (63.3%) developed AGA, including 31% who developed moderate-to-severe AGA. Several prospective studies have shown rates of AGA among TGD patients receiving MHT ranging between 5% to 17% within the first year of therapy.2,3 These rates appear to be affected by the age of patients started on MHT and the presence of a family history of AGA.4 In general, it appears that TGD individuals develop AGA within 2 to 5 years of starting MHT.1-5 In this study, we examine the proportion of a large population of TGD patients receiving MHT who developed AGA over the course of a mean duration of 3.4 years as well as medications prescribed for AGA among this cohort.