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Research Letter
February 10, 2021

Incidence and Factors Associated With Androgenetic Alopecia Among Transgender and Gender-Diverse Patients Treated With Masculinizing Hormone Therapy

Author Affiliations
  • 1Boston University School of Medicine, Boston, Massachusetts
  • 2The Fenway Institute, Fenway Health, Boston, Massachusetts
  • 3Beth Israel Deaconess Medical Center, Department of Dermatology, Boston, Massachusetts
  • 4Beth Israel Deaconess Medical Center, Department of Medicine, Boston, Massachusetts
  • 5Harvard Medical School, Boston, Massachusetts
  • 6Kaiser Permanente Mid-Atlantic Permanente Medical Group, Department of Dermatology, Rockville, Maryland
JAMA Dermatol. 2021;157(3):348-349. doi:10.1001/jamadermatol.2020.5475

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.

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